PMID- 34552724
OWN - NLM
STAT- MEDLINE
DCOM- 20210924
LR  - 20220426
IS  - 2047-2986 (Electronic)
IS  - 2047-2978 (Print)
IS  - 2047-2978 (Linking)
VI  - 11
DP  - 2021
TI  - A comparative analysis and review of how national guidelines for chronic disease 
      monitoring are made in low- and middle-income compared to high-income countries.
PG  - 04055
LID - 10.7189/jogh.11.04055 [doi]
LID - 04055
AB  - BACKGROUND: Understanding how clinical practice guidelines and recommendations 
      are adopted in high-income and low-income settings will help contextualise the 
      value and validity of recommendations in different settings. We investigate how 
      major guidelines and recommendations are developed for management and monitoring 
      of post-diagnosis treatment for three important chronic diseases: HIV, 
      hypertension and type 2 diabetes mellitus (T2DM). METHODS: Eligible guidelines 
      were searched for using PubMed, Google, and health ministry websites for all 
      three conditions. Only guidelines published from 2010 to 2020 were included. The 
      source of the guidelines, year of most recent guideline, and basis of the 
      guidelines were assessed. Additionally, recommendations, the strength of the 
      recommendation and the quality of the evidence for treatment goals of 
      non-pregnant adults and the frequency of monitoring were also extracted and 
      assessed. RESULTS: Of the 42 countries searched 90%, 71% and 60% had T2DM, 
      hypertension and HIV guidelines outlining targets for long-term management, 
      respectively. Most T2DM guidelines recommend an HbA1c target of </=7.0% (68%) or 
      </=6.5% (24%) as the ideal glycaemic target for most non-pregnant adults, while 
      hypertension guidelines recommend blood pressure (systolic blood 
      pressure/diastolic blood pressure) targets of <140/90 mm Hg (94%) and <130/80 mm 
      Hg (6%). Of the identified HIV guidelines, 67% define virological failure as a 
      viral load >1000 copies/mL, with 26%, mostly HICs, defining virological failure 
      as a viral load >200 copies/mL. Recommendations for the frequency of monitoring 
      for any diagnosed patients were available in 18 (55%) of the hypertension 
      guidelines, 25 (93%) of HIV guidelines, and 27 (73%) of the T2DM guidelines. Only 
      a few of the guidelines provide the strength of the recommendation and the 
      quality of the evidence. CONCLUSIONS: Most guidelines from LMICs are adopted or 
      adapted from existing HIC guidelines or international and regional organisation 
      guidelines with little consideration for resource availability, contextual 
      factors, logistical issues and general feasibility.
CI  - Copyright (c) 2021 by the Journal of Global Health. All rights reserved.
FAU - Mukonda, Elton
AU  - Mukonda E
AD  - Division of Epidemiology & Biostatistics, School of Public Health & Family 
      Medicine, University of Cape Town, Cape Town, South Africa.
FAU - Lesosky, Maia
AU  - Lesosky M
AD  - Division of Epidemiology & Biostatistics, School of Public Health & Family 
      Medicine, University of Cape Town, Cape Town, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20210904
PL  - Scotland
TA  - J Glob Health
JT  - Journal of global health
JID - 101578780
SB  - IM
MH  - Adult
MH  - Developed Countries
MH  - *Diabetes Mellitus, Type 2/diagnosis/therapy
MH  - Humans
MH  - *Hypertension/diagnosis/therapy
MH  - Income
MH  - Viral Load
PMC - PMC8442582
COIS- Competing interests: The authors completed the ICMJE Declaration of Interest Form 
      (available upon request from the corresponding author) and declare no conflict of 
      interest.
EDAT- 2021/09/24 06:00
MHDA- 2021/09/25 06:00
PMCR- 2021/09/04
CRDT- 2021/09/23 06:51
PHST- 2021/09/23 06:51 [entrez]
PHST- 2021/09/24 06:00 [pubmed]
PHST- 2021/09/25 06:00 [medline]
PHST- 2021/09/04 00:00 [pmc-release]
AID - jogh-11-04055 [pii]
AID - 10.7189/jogh.11.04055 [doi]
PST - epublish
SO  - J Glob Health. 2021 Sep 4;11:04055. doi: 10.7189/jogh.11.04055. eCollection 2021.