The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE IIReportar como inadecuado




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BMC Complementary and Alternative Medicine

, 16:425

Integration into healthcare

Abstract

BackgroundComplementary and alternative medicine CAM use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines.

MethodsA systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II AGREE II instrument.

ResultsFrom 3,126 unique search results, 17 guidelines two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation 85.3 %, scope and purpose 83.3 %, rigour of development 61.2 %, editorial independence 60.1 %, stakeholder involvement 52.0 % and applicability 20.7 %. Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications.

ConclusionsGuidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available to support guideline development and implementation. Future research should identify CAM therapies other than those reviewed here for which guidelines are available. Research is also needed on the safety and effectiveness of CAM therapies.

KeywordsComplementary and alternative medicine Integrative medicine Systematic review AGREE II Clinical practice guideline AbbreviationsAGREE IIAppraisal of guidelines for research and evaluation II

BMC CAMBioMedCentral complementary and alternative medicine

CAMComplementary and alternative medicine

JACMJournal of complementary and alternative medicine

NCCIHNational Center for Complementary and Integrative Health

NGCNational Guideline Clearinghouse

PICOPatients, intervention, comparison and outcomes

PRISMAPreferred reporting items for systematic reviews and meta-analyses

Electronic supplementary materialThe online version of this article doi:10.1186-s12906-016-1410-8 contains supplementary material, which is available to authorized users.

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Autor: Jeremy Y. Ng - Laurel Liang - Anna R. Gagliardi

Fuente: https://link.springer.com/







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