Sunshine Coast Mental Health and Addiction Services, Maroochydore, Qld 4558, Australia.; and Corresponding author. Email:
Metro North Mental Health Service, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia. Email:
Aust Health Rev. 2020 Dec;44(6):904-915. doi: 10.1071/AH20080.
Objectives The aim of this study was to identify current physical health guidelines for severe mental illness (SMI) and appraise them using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Methods Relevant research databases and grey literature were systematically searched to identify physical health guidelines for people with SMI. The grey literature was explored by web searches and targeted searches of the English websites of relevant peak bodies and government health agencies from Organisation for Economic Co-operation and Development countries. Included guidelines were independently appraised by two authors (NF and JH) using the AGREE II Instrument. Results Of the 5352 records screened, 33 were assessed for eligibility. Fifteen practice guidelines met the inclusion criteria. The median domain scores as rated by the AGREE II Instrument ranged from 17% to 69%. The World Health Organization guideline, which demonstrated a broad range of clinical recommendations and sound methodological rigour, was rated the best. Conclusions Most guidelines scored poorly when rated by the AGREE II Instrument. However, these guidelines may still be useful in assisting evidence-based clinical practice. The methodological rigour of future guidelines can be improved by ensuring the AGREE II domains are addressed during the development phase. What is known about the topic? Compared with the general population, people with SMI experience greater chronic disease morbidity and mortality. There is limited evidence from randomised controlled trials to guide physical health care monitoring for people with SMI. Current guidelines and practice are largely based on expert consensus, clinical experience and good intentions. What does this paper add? Using the AGREE II Instrument, this paper appraises the current physical health guidelines for people with SMI. The attributes of the guidelines examined included the evidence base, clarity of presentation, applicability in the real world, the involvement of stakeholders and conflicts of interest of various parties involved in guideline development. What are the implications for practitioners? This review highlights the scarcity of high-quality and evidence-based guidelines for clinicians and researchers to address the physical health of people with SMI.
本研究旨在确定严重精神疾病（SMI）的当前身体健康指南，并使用评估健康指南研究与评价（AGREE II）工具对其进行评估。
系统搜索相关研究数据库和灰色文献，以确定针对 SMI 患者的身体健康指南。通过网络搜索和对经合组织国家相关机构的英文网站进行有针对性的搜索，探索灰色文献。两名作者（NF 和 JH）独立使用 AGREE II 工具对纳入的指南进行评估。
在筛选的 5352 条记录中，有 33 条被评估为符合条件。15 项实践指南符合纳入标准。AGREE II 工具评定的各领域得分中位数范围为 17%至 69%。世界卫生组织的指南得分最高，该指南展示了广泛的临床建议和良好的方法学严谨性。
根据 AGREE II 工具评分，大多数指南的得分都较低。然而，这些指南在协助基于证据的临床实践方面可能仍然有用。通过确保在制定阶段解决 AGREE II 各领域问题，可以提高未来指南的方法学严谨性。
与一般人群相比，患有 SMI 的人患有更多的慢性疾病发病率和死亡率。针对 SMI 患者进行身体健康护理监测的随机对照试验证据有限。目前的指南和实践主要基于专家共识、临床经验和良好意愿。
本文添加了什么内容？本文使用 AGREE II 工具评估了针对 SMI 患者的当前身体健康指南。所检查的指南属性包括证据基础、表述清晰度、在现实世界中的适用性、利益相关者的参与以及参与指南制定的各方的利益冲突。
对从业者的意义是什么？本综述强调了高质量和基于证据的指南对于临床医生和研究人员在解决 SMI 患者身体健康问题方面的稀缺性。
