Critical appraisal of tobacco dependence treatment guidelines

Maguy Saffouh El Hajj,Myriam Jaam,Kyle John Wilby,Saba Abdal Salam Sheikh Ali,Ahmed Awaisu,Bridget Paravattil,Rana Saleh

doi:10.1007/s11096-020-01110-4

Abstract

Background Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations. Objective The study objective is to identify and critically appraise the quality of existing clinical practice guidelines for tobacco cessation. Setting The study occurred between collaborative academic institutions located in Qatar and New Zealand. Methods A systematic literature search was performed for the period 2006–2018 through the following databases: PubMed, EMBASE, CINAHL, ISI Web of Science, Scopus, National Guideline Clearing House, Campbell Library, Health System Evidence, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, PROSPERO, and Google Scholar. Relevant professional societies’ and health agencies’ websites were also searched. Two reviewers independently extracted and assessed guidelines’ quality using Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Main outcome measure Standardized domain scores according to the AGREE II instrument. Results 7741 hits were identified. After removing duplicates and screening, 24 guidelines were included. Highest guideline quality was for National Institute for Health and Care Excellence (NICE) guideline with an overall ranking score of 87.56% and least quality was for Japanese Circulation Society Joint Working Group with an overall score of 29.34%. Domain 4 of AGREE II (clarity of presentation) had the highest average quality score (70.95%), while the lowest average quality scores were for Domain 2 (Rigour of Development) (50.21%) and Domain 5 (Applicability) (45.05%). Conclusion Seven guidelines were judged to be of high quality (overall score of ≥ 70%). Future guidelines for tobacco dependence treatment should use rigorous methods of development and provide applicable recommendations.

Highlights

Aim of the studyTobacco use and dependence is a leading preventable cause of morbidity and mortality globally, and is strongly linked to numerous diseases and healthcare burden [1]
After removing duplicates and screening, a total of 24 guidelines related to tobacco cessation that satisfied the study eligibility criteria were identified and evaluated (Fig. 1)
Seven guidelines were considered of high quality with an overall score of > 70% [18, 19, 21, 23, 29, 34, 35]

Summary

Introduction

Tobacco use and dependence is a leading preventable cause of morbidity and mortality globally, and is strongly linked to numerous diseases and healthcare burden [1]. Concerted efforts have been put in place to reduce the global smoking prevalence, many countries continue to record high smoking rates, resulting in increased disease burden and healthcare expenditures [2, 3]. Tobacco cessation interventions play an important role in addressing tobacco-related health risks and mortality. The role for healthcare providers in implementing tobacco cessation interventions within their clinical practice settings becomes unequivocally important. Clinicians use tobacco cessation tools and resources such as clinical practice guidelines (CPGs) to provide tobacco use dependence management. Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations

Methods

Results

Discussion

Conclusion