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.

摘要

背景：东南亚高血压的流行以及不受控制的高血压的高患病率表明，高质量的临床实践指南 (CPG) 在优化高血压管理方面发挥着重要作用。然而，东南亚没有关于 CPG 管理高血压的质量评估报告。

目的：本研究旨在使用经过验证的质量评估工具评估东南亚高血压管理 CPG 的方法学质量。

方法：从东南亚各国卫生部网站或心血管专业学会网站检索东南亚高血压管理CPGs。两名具有学术背景的审阅者使用指南研究和评估评估 (AGREE II) 工具独立评估所有纳入 CPG 的方法学质量。

结果：确定了六个 CPG，每个都来自泰国、马来西亚、印度尼西亚、文莱、新加坡和越南。得分最高的质量领域是“呈现的清晰度”（平均值 = 78.7 ± 14.6%），而得分最低的质量领域是“适用性”和“编辑独立性”（平均值 = 8.4 ± 6.0% 和平均值 = 8.3 ± 18.6 ％， 分别）。除了源自马来西亚的 CPG 被“推荐”用于实践（三个领域的标准化得分≥50.0%），其余五个 CPG 被“弱推荐”用于实践（一到两个领域的标准化得分为≥50%）。

结论：需要更多的努力来提高已开发的用于东南亚高血压管理的 CPG 的质量。