Department of Pharmacology & Therapeutics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Mumbai, India.
National Chair of Clinical Pharmacology, Indian Council of Medical Research, New Delhi, India.
Indian J Med Res. 2019 Jun;149(6):715-729. doi: 10.4103/ijmr.IJMR_902_17.
BACKGROUND & OBJECTIVES: Standard treatment guidelines (STGs) are the cornerstone to therapeutics. Multiple agencies in India develop STGs. This systematic review was conducted to find out STGs available in India, evaluate if these were as per World Health Organization (WHO) recommendations for STGs and compare these with National Institute for Health and Care Excellence (NICE) guidelines. Information on legal authority and responsibility for formulating STGs was also sought.
PRISMA guidelines were followed. Publications from PubMed and Google Scholar were searched for STGs using terms 'Standard Treatment Guidelines AND India'. Data from STGs were compiled in excel as per the WHO and authors' criteria for STGs and compared with NICE guidelines.
PubMed and Google Scholar search provided 56 publications (out of 1695 search results) mentioning 27 STGs. Google search and replies from authors led us 36 STGs, totalling to 63 STGs. No STG mentioned any specific period of revision, eight STGs were not evidence-based, 55 had some Indian references, 48 STGs were for single disease and the remaining multi-disease, three STGs did not include diagnostic criteria, 16 STGs did not give prescribing information of recommended treatment and 16 STGs provide no referral criteria for patients. Fifty five STGs did not mention level of health care. While NICE is a single legal authority in England and guidelines are as per WHO recommendations for STGs, in India although Acts and rules do not vest authority, National Health Systems Resource Center is generally designated responsible for STGs.
INTERPRETATION & CONCLUSIONS: In India, although there are multiple STGs developed by various authorities and professionals for the same conditions, these fulfil WHO recommendations only partially. Authority with statutory duty collaborating with professional organizations, a standard methodology for adopting international guidelines, Indian data for evidence base, attention to local needs will help in developing better STGs and their acceptance.
标准治疗指南（STGs）是治疗的基石。印度的多个机构制定 STGs。本系统评价旨在找出印度现有的 STGs，评估它们是否符合世界卫生组织（WHO）对 STGs 的建议，并将其与英国国家卫生与保健卓越研究所（NICE）指南进行比较。还寻求了有关制定 STGs 的法律权威和责任的信息。
遵循 PRISMA 指南。使用术语“标准治疗指南 AND 印度”在 PubMed 和 Google Scholar 上搜索 STGs 出版物。根据 WHO 和作者制定 STGs 的标准，将 STGs 的数据汇总到 Excel 中，并与 NICE 指南进行比较。
PubMed 和 Google Scholar 搜索提供了 56 篇出版物（在 1695 条搜索结果中），其中提到了 27 项 STGs。Google 搜索和作者的回复使我们找到了 36 项 STGs，总计 63 项 STGs。没有 STG 提到任何特定的修订期限，8 项 STG 不是基于证据的，55 项 STG 有一些印度参考文献，48 项 STG 是针对单一疾病的，其余的是多疾病的，3 项 STG 不包括诊断标准，16 项 STG 没有提供推荐治疗的处方信息，16 项 STG 没有为患者提供转诊标准。55 项 STG 没有提到医疗保健水平。虽然 NICE 是英格兰的单一法律权威，指南符合 WHO 对 STGs 的建议，但在印度，尽管法案和规则没有赋予权力，但国家卫生系统资源中心通常被指定负责 STGs。
在印度，虽然有多个由不同机构和专业人员为相同条件制定的 STGs，但这些 STGs 仅部分符合 WHO 的建议。具有法定职责的权威机构与专业组织合作，采用国际指南的标准方法，基于印度数据的证据基础，关注当地需求，将有助于制定更好的 STGs 并得到接受。
