Quality of clinical practice guidelines for the management of hypertension in six Southeast Asian countries

Abstract

ABSTRACT Background: The endemic of hypertension along with high prevalence of uncontrolled hypertension in Southeast Asia indicates an important role for high-quality clinical practice guidelines (CPGs) to optimize the management of hypertension. However, there was no reported quality appraisal of the CPGs for the management of hypertension in Southeast Asia. Objective: This study aimed to evaluate methodological quality across the CPGs for the management of hypertension in Southeast Asia with a validated quality appraisal tool. Methods: The CPGs for the management of hypertension in Southeast Asia were retrieved from the websites of the Ministry of Health or cardiovascular specialty societies of the individual countries of Southeast Asia. Two reviewers with academic backgrounds independently appraised the methodological quality of all the included CPGs using the Appraisal of Guideline ResEarch and Evaluation (AGREE II) instrument. Results: Six CPGs were identified, each of them from Thailand, Malaysia, Indonesia, Brunei, Singapore, and Vietnam. The highest-scoring quality domain was ‘clarity of presentation’ (mean=78.7 ± 14.6%), whereas the lowest-scoring quality domains were ‘applicability’ and ‘editorial independence’ (mean=8.4 ± 6.0% and mean=8.3 ± 18.6%, respectively). Except for the CPG originated from Malaysia which was “recommended“ for use in practice (standardized score for three domains was ≥50.0%), the remaining five CPGs were “weakly recommended” for use in practice (standardized score for one to two domains was ≥50%). Conclusion: More efforts are needed to improve the quality of the developed CPGs for the management of hypertension in Southeast Asia.