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

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Global Alliance for Chronic Diseases (GACD) Mental Health Guidelines Working Group - (Author)
  • University of Toronto
  • Queen's University Kingston
  • Southwest University
  • McGill University
  • Pontificia Universidad Católica de Chile
  • Ulm University
  • University of Copenhagen
  • National Institute for Health and Welfare
  • University of Queensland
  • University of Kansas
  • WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation
  • Wellcome Trust
  • University of Ibadan
  • The University of Tokyo
  • Inje University
  • Chiang Mai University
  • Sun Yat-Sen University
  • University of Valencia
  • University of Groningen
  • Gyeongsang National University
  • Leiden University
  • Division of Country Health Programme
  • Psychiatric and Neurological Hospital
  • University of Otago
  • Swedish National Board of Health and Welfare
  • Universiti Kebangsaan Malaysia
  • Human Development Research Foundation
  • University of the Philippines
  • Singapore Institute of Mental Health
  • Dalhousie University

Abstract

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.

Details

Original languageEnglish
Pages (from-to)683-697H
Journal Bulletin of the World Health Organization : the international journal of public health = Bulletin de l'Organisation Mondiale de la Santé
Volume98
Issue number10
Publication statusPublished - Oct 2020
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 33177758
ORCID /0000-0001-7018-6021/work/168207920

Keywords