Factors Associated with High-Quality Guidelines for the Pharmacologic Management of Chronic Diseases in Primary Care: A Systematic Review

Molino CGRC, Leite-Santos NC, Gabriel FC, et al. JAMA Intern Med. 2019 Feb 18. [Epub ahead of print] [CrossRef] [PubMed]

The authors assessed 421 clinical practice guidelines (CPGs) in primary care using the validated Appraisal of Guidelines for Research and Evaluation Instrument, version II (AGREE-II) tool. A multiple logistic regression was performed to identify factors associated with quality of CPGs. Of the CPGs reviewed only 23.5% (99) were classified as high quality. Factors associated with high-quality CPGs included having more than 20 authors (odds ratio, 9.08; 95%CI, 3.35-24.62), development at governmental institutions (odds ratio, 10.38; 95%CI, 2.72-39.60), and reporting funding (odds ratio, 10.34; 95%CI, 4.77-22.39). Year of publication, region, guideline version, and scope were not associated with quality among included CPGs. An accompanying editorial discusses the implications of the study and argues that only high quality guidelines should be implemented. The study agrees with previous publications examining the quality of non-primary care guidelines including the Infectious Disease Society of America and American Thoracic Society by Lee et al. in 2011 and several publications in the SWJPCC examining ICU guidelines.