Zhongguo quanke yixue (Dec 2022)

Clinical Guidelines Analysis and Quality Assessment of Guidelines for Hypertension in the Elderly

  • TIAN Xintong, MA Teng, SUN Xuan, YANG Ji, ZHAO Yingqiang

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0323
Journal volume & issue
Vol. 25, no. 34
pp. 4259 – 4266,4285

Abstract

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Background Older people are a group susceptible to hypertension, and among whom hypertension prevalence is increasing as population aging aggravates. Early prevention, diagnosis and treatment of hypertension in the elderly are very important, which can be enhanced by an important way, namely developing high-quality clinical practice guidelines. Objective To perform an analysis of the guidelines regarding the diagnosis and management of hypertension in the elderly, and to assess their methodological quality. Methods In December 2021, we searched for clinical guidelines for hypertension in the elderly in databases of CNKI, CQVIP, WanFang Data, SinoMed, PubMed, EmBase and Medlive, as well as in the official websites of the National Guideline Clearing house, the Guidelines International Network and the National Institute for Health and Care Excellence from inception to December 2021. Two reviewers independently conducted literature screening and data extraction. Four reviewers independently evaluated the methodological quality of included guidelines using the AGREEⅡ. Recommendations from each guideline were retrieved. Results A total of 11 guidelines were included: seven are Chinese guidelines, two are US guidelines and the other two are European guidelines. The mean standardized domains scores of the AGREEⅡinstrument in assessing the overall guideline quality were as follows: 50.13% for scope and purpose, 24.24% for stakeholder involvement, 18.51% for rigour of development, 54.03% for clarity of presentation, 11.36% for applicability and 30.30% for editorial independence. The recommendation level was B for five guidelines, and was C for the remaining six guidelines. The main recommendations involve three aspects: pharmacological intervention, non-pharmacological intervention, and continuing health management. Conclusion The overall methodological quality of included guidelines is unsatisfactory. To improve the quality of such guidelines developed in the future to better guide clinical practice, it is suggested to give more attention and priority to domains of stakeholder involvement, rigour of development, and applicability.

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