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采用 ADAPTE 方法制定广泛性焦虑障碍治疗指南。

Development of a guideline for the treatment of generalized anxiety disorder with the ADAPTE method.

机构信息

Mental Health Unit, Regional University Hospital, Málaga 29009, Spain.

Institute of Biomedical Research of Málaga (IBIMA), Spain.

出版信息

Int J Qual Health Care. 2020 Jul 20;32(6):356-363. doi: 10.1093/intqhc/mzaa053.

Abstract

OBJECTIVE

The aim was to develop a clinical guideline for managing generalised anxiety disorder in Primary Health Care and Mental Health, using guideline adaptation methods.

DESIGN

A clinical guideline was developed, following the methods of the ADAPTE group, and implemented in a Primary Health Care District and in Mental Health Services in Spain.

SETTING

Regional University Hospital of Málaga and District of Primary Health Care Málaga-Guadalhorce (Spain).

PARTICIPANTS

The participants were family physicians, psychiatrists and clinical psychologists. The phases of the process included definition of clinical scenarios, literature search and guidelines appraisal, elaboration of recommendations, conducting focus groups with users diagnosed with generalised anxiety disorder, linking the testimonials of users with recommendations, external review and implementation by multifaceted interventions.

RESULTS

The final release included 49 Recommendations, of which 47 are from the 2011 NICE guidance for GAD and 2 of the 2011 NICE guideline for common mental disorder. Finally, seven recommendations needed to be adapted to the Spanish health care context, and three recommendations were excluded.

CONCLUSIONS

A guideline aimed to improve the quality and effectiveness of the care provided to people with generalised anxiety disorder has been released. The use of adaptation methods has simplified the use of resources and time. This guideline and the process designed for its implementation constitute a suitable collection of resources for the improvement on detection and treatment of GAD in primary health care. Adaptation methods play a key role in the knowledge translation continuum.

摘要

目的

旨在使用指南适应方法为初级保健和精神卫生制定广泛性焦虑障碍的临床管理指南。

设计

遵循 ADAPTE 小组的方法制定了临床指南,并在西班牙的一家初级保健区和精神卫生服务机构实施。

设置

马拉加地区大学医院和马拉加瓜达尔霍斯初级保健区(西班牙)。

参与者

家庭医生、精神科医生和临床心理学家。该过程的各个阶段包括定义临床情况、文献检索和指南评估、制定建议、对被诊断为广泛性焦虑障碍的患者进行焦点小组讨论、将患者的意见与建议联系起来、外部审查以及通过多方面的干预措施进行实施。

结果

最终发布的指南包括 49 条建议,其中 47 条来自 2011 年 NICE 对广泛性焦虑障碍的指导,2 条来自 2011 年 NICE 对常见精神障碍的指导。最终,需要适应西班牙医疗保健背景的 7 条建议,以及需要排除的 3 条建议。

结论

发布了旨在提高广泛性焦虑障碍患者护理质量和效果的指南。适应方法的使用简化了资源和时间的使用。该指南和为其实施设计的过程为改善初级保健中广泛性焦虑症的检测和治疗提供了合适的资源集合。适应方法在知识转化连续体中起着关键作用。

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