Quality of Palliative Care Guidelines in Patients with Heart Failure: A Systematic Review of Quality Appraisal using AGREE II Instrument.

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
Indian Journal of Palliative Care Pub Date : 2023-01-01 Epub Date: 2022-08-23 DOI:10.25259/IJPC_46_2022
Imane Bagheri, Hojatollah Yousefi, Masoud Bahrami, Davood Shafie
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引用次数: 0

Abstract

Objectives: While the principles for developing clinical practice guidelines (CPGs) are well established, the quality of published guidelines is very diverse. The present study was conducted to evaluate the quality of existing CPGs in palliative care for heart failure patients.

Material and methods: The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses. A systematic search was conducted in the Excerpta Medica Database, MEDLINE/PubMed, CINAHL databases and Guideline internet sites: National Institute for Clinical Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, Guidelines International Network and National Health and Medical Research Council for CPGs published through April 2021. Criteria for including CPGs were: Containing palliative measures for patients with heart failure over 18 years old and preferably interprofessional guidelines that focus on only one dimension of palliative care or focus on diagnosis, definition and treatment were excluded from the study. After initial screening, five appraisers rated the quality of the final selection of CPGs using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II).

Results: From 1501 records, seven guidelines were selected for analysis. The 'scope and purpose' and 'clarity of presentation' domains obtained the highest mean and 'rigor of development' and 'applicability' domains obtained the lowest mean scores. Three categories of recommendations were: (1) Strongly recommended (guidelines 1, 3, 6 and 7); (2) recommended with modifications (guideline 2) and (3) not recommended (guidelines 4 and 5).

Conclusion: Clinical guidelines for palliative care in patients with heart failure were of moderate-to-high quality, with the main deficiencies occurring in the rigor of development and applicability domains. The results inform clinicians and guideline developers of the strengths and weaknesses of each CPG. To improve the quality of palliative care CPGs in the future, it is recommended that developers pay detailed attention to all domains of the AGREE II criteria. Funding agent: Isfahan University of Medical Sciences. (IR.MUI.NUREMA.REC.1400.123).

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心力衰竭患者的姑息治疗质量指南:使用AGREE II仪器进行质量评估的系统回顾。
目的:虽然制定临床实践指南(CPG)的原则已经确立,但已发布的指南的质量非常多样化。本研究旨在评估心力衰竭患者姑息治疗中现有CPG的质量。材料和方法:本研究根据系统评价和荟萃分析的首选报告项目进行。在医学摘录数据库、MEDLINE/PubMed、CINAHL数据库和指南网站中进行了系统搜索:国家临床卓越研究所、国家指南信息交换所、苏格兰校际指南网络、指南国际网络和国家健康与医学研究委员会,发布至2021年4月。纳入CPG的标准是:包含针对18岁以上心力衰竭患者的姑息治疗措施,最好是只关注姑息治疗的一个方面或专注于诊断、定义和治疗的跨专业指南被排除在研究之外。经过初步筛选,五名评估人员使用《研究与评估指南评估》第二版(AGREE II)对CPG的最终选择质量进行了评级。结果:从1501份记录中,选择了七份指南进行分析。“范围和目的”和“展示的清晰度”领域获得了最高的平均值,“开发的严格性”和“适用性”领域获得的平均值最低。三类建议是:(1)强烈建议(准则1、3、6和7);(2) 建议修改(指南2)和(3)不建议(指南4和5)。结论:心力衰竭患者姑息治疗的临床指南质量中等至较高,主要缺陷出现在制定的严格性和适用性领域。结果告知临床医生和指南制定者每个CPG的优势和劣势。为了在未来提高姑息治疗CPG的质量,建议开发人员详细关注AGREE II标准的所有领域。资助机构:伊斯法罕医学科学大学。(第140.123号决议)。
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来源期刊
Indian Journal of Palliative Care
Indian Journal of Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.30
自引率
0.00%
发文量
57
期刊介绍: Welcome to the website of the Indian Journal of Palliative Care. You have free full text access to recent issues of the journal. The links connect you to •guidelines and systematic reviews in palliative care and oncology •a directory of palliative care programmes in India and IAPC membership •Palliative Care Formulary, book reviews and other educational material •guidance on statistical tests and medical writing.
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