Adopting Clinical Practice Guidelines for Pharmacologic Management of Acute Spinal Cord Injury from a Developed World Context to a Developing Global Region

Author:

Jazayeri Seyed Behnam1ORCID,Maroufi Seyed Farzad12,Ghodsi Zahra13,Ghawami Heshmatollah4,Pourrashidi Ahmad5,Amirjamshidi Abbas5,Mojtahedzadeh Mojtaba56,Arabkheradmand Jalil7,Farahbakhsh Farzin81,Shabany Maryam21,Faghih-Jouibari Morteza9,Fehlings Michael G.10,Kwon Brian K.1112,Harrop James S.13,Rahimi-Movaghar Vafa139ORCID

Affiliation:

1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

2. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

3. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

4. Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

5. Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

6. Director of Fellowship Program in Clinical Pharmacy and Critical Care, Faculty of Pharmacy

7. Director, Defence Health Research C, Tehran, Iran

8. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

9. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

10. University of Toronto Spine Program and Toronto Western Hospital, Toronto, Ontario, Canada

11. International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada

12. Department of Orthopaedics, Division of Spine, University of British Columbia, Vancouver, BC, Canada

13. Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients’ outcomes on the ability and knowledge of "individual" health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute spinal cord injury (SCI) using guideline adaptation methods. Methods: This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each suggestion and the triad of feasibility, acceptance and adoptability for the Iranian health-care context. Results: Two guidelines were included in the adaptation process. Based on high-quality of these guidelines and the feasibility and adoptability evaluation of the organizing committee, we decided to adopt the suggestion of both guidelines. Overall, seven suggestions were extracted from the source guidelines. Conclusion: This work provides a framework to apply guidelines for acute SCI to the developing regions of the world. Attempts should be made to implement these suggestions in order to improve the health outcomes of Iranian SCI patients.

Publisher

Maad Rayan Publishing Company

Subject

General Medicine

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