An Evaluation of African Clinical Practice Guidelines

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Presentation transcript:

An Evaluation of African Clinical Practice Guidelines Patrick Mbah Okwen1,2, Irene Maweu3, Janine Margarita Dizon4, Karen Grimmer5 Introduction Good quality clinical practice guidelines (CPGs) provide believable summaries of current evidence to support clinical decisions that improve health outcomes. African nations are challenged by high burdens from communicable and non-communicable diseases. Hypertension is a prevalent non-communicable disease with disastrous sequelae such as stroke, heart and kidney disease. The quality and consistency of management of hypertension in Africa could be improved by universal application of good quality CPGs. This paper reports on a review of the quality of current pan-African CPGs for hypertension. Results: Of 61 African nations contacted, 25 used formal guidance for hypertension. Most treatment guidance was provided by WHO. No CPG scored well on all AGREE domain scores. The domains with the poorest scores were Rigour of Development, Stakeholder Involvement, Applicability and Editorial Independence. There were no significant score difference between pre- and post-2011 CPGs. There were inconsistent AGREE scores between all reviews, considering the same CPGs. Conclusions: The quality of hypertension CPGs in pan-African nations requires improvement, and the need for so many CPGs could be questioned. Variability in quality scoring highlights difficulties with using the AGREE II 1-7 scoring system, particularly for variable quality CPGs. Adopting evidence from international good quality CPGs and layering it with local contexts offers a way to efficiently improve African hypertension CPG quality. here. Methods A comprehensive search for pan-African CPGs for hypertension was undertaken from inception until 2016. Freely available, English-language guidance was sought. CPG quality was assessed using AGREE II, scored by two independent reviewers. Differences in the AGREE II domain scores were compared between CPGs written prior to 2011, and 2011 onwards. Findings were compared with earlier African CPG reviews undertaken in 2011 and 2014. Disclosure Authors of this presentation have no disclosures to make. The AGREE II evaluation was done solely on private time by two GIN Africa members Perspectives Publications Guidelines adaptation or contextualization workshop. Additional information here about the authors or the name of the conference