Development and implementation of guidelines for the management of depression: A systematic review

• Main Authors: Yena Lee, Elisa Brietzke, Bing Cao, Yan Chen, Outi Linnaranta, Rodrigo B. Mansur, Paulina Cortes, Markus Kösters, Amna Majeed, Jocelyn K. Tamura, Leanna M.W. Lui, Maj Vinberg, Jaakko Keinänen, Steve Kisely, Sadiq Naveed, Corrado Barbui, Gary Parker, Mayowa Owolabi, Daisuke Nishi, Junggoo Lee, Manit Srisurapanont, Hartej Gill, Lan Guo, Vicent Balanzá-Martínez, Timo Partonen, Willem A. Nolen, Jae Hon Lee, Ji Hwan Kim, Niels H. Chavannes, Tatjana Ewais, Beatriz Atienza-Carbonell, Anna V. Silven, Naonori Yasuma, Artyom Gil, Andrey Novikov, Cameron Lacey, Anke Versluis, Sofia von Malortie, Lai Fong Chan, Ahmed Waqas, Marianna Purgato, Jiska Joëlle Aardoom, Josefina T. Ly-Uson, Kang Sim, Maria Tuineag, Rianne M.J.J. van der Kleij, Sanne van Luenen, Sirijit Suttajit, Tomas Hajek, Yu Wei Lee, Richard J. Porter, Mohammad Alsuwaidan, Joshua D. Rosenblat, Arun V. Ravindran, Raymond W. Lam, Roger S. McIntyre
• Format: Journal
• Published: 2020
• Subjects: Medicine
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85091981562&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/70759
• Institution: Chiang Mai University

© 2020, World Health Organization. All rights reserved. Objective To evaluate the development and implementation of clinical practice guidelines for the management of depression globally. Methods We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low-and middle-income countries with those from high-income countries. Findings We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low-and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low-and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low-and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low-and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence. Conclusion Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low-and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost–effectiveness and impact on health outcomes.