Methodological quality of guidelines for the management of opioid use disorder: A systematic review

Watan Pal, Abuzar and Aziz, Zoriah and Kamarulzaman, Adeeba (2021) Methodological quality of guidelines for the management of opioid use disorder: A systematic review. Journal of Clinical Pharmacy and Therapeutics, 46 (6). pp. 1531-1548. ISSN 0269-4727, DOI https://doi.org/10.1111/jcpt.13449.

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Abstract

What is known and objective Opioid Use Disorder (OUD) has a high mortality rate and affects millions of people worldwide. Many organizations and societies develop Clinical Practice Guidelines (CPGs) to serve as a framework for healthcare providers to decide and support best practice to manage and treat OUD. However, not all CPGs sufficiently address all the important aspects of optimal care for managing OUD. This study aims to review current CPGs for management of OUD, evaluate their methodological quality and summarize their recommendations. Methods We conducted this systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Various databases were searched for CPGs and Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument was used to assess the methodological quality. We also summarized the treatments plans of CPGs across continuum of care (diagnosis and assessment, treatment initiation, pharmacotherapy and psychosocial). Results This review included 28 CPGs of varying qualities. CPGs from high-income countries and international organizations rated high for their methodological quality. Most CPGs scored high for the scope and purpose domain and scored low for applicability domain. Recommendations for the continuum of care for OUD varied across CPGs. Buprenorphine was recommended in most of the CPGs, followed by methadone. Recommendations for psychosocial interventions also varied, with cognitive behaviour therapies and counselling or education being the common recommendations in many CPGs What is new and conclusion We found most CPGs have scope and purpose and clarity of presentation. However, the methodological rigour and applicability scored low. CPGs need to frame health questions in a comprehensible manner and provide an update as evidence grows. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: AGREE-II instrument; Clinical recommendations; Opioid dependence; Practice guideline; Psychosocial management; Quality appraisal
Subjects: R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 26 May 2022 03:51
Last Modified: 26 May 2022 03:51
URI: http://eprints.um.edu.my/id/eprint/27170

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