Bashiri Fahad A, Albatti Turki H, Hamad Muddathir H, Al-Joudi Haya F, Daghash Hadeel F, Al-Salehi Saleh M, Varnham Jeremy L, Alhaidar Fatimah, Almodayfer Omar, Alhossein Abdulkarim, Aldhalaan Hesham, Ad-Dab'bagh Yasser A, Al Backer Nouf, Altwaijri Waleed, Alburikan Khalid, Buraik Maysaa W, Ghaziuddin Mohammad, Nester Michael J, Wahabi Hayfaa A, Alhabib Samia, Jamal Amr A, Amer Yasser S
Pediatrics Department, Pediatric Neurology Division, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Saudi Pediatric Neurology Society, Riyadh, Saudi Arabia.
Child Adolesc Psychiatry Ment Health. 2021 Feb 8;15(1):6. doi: 10.1186/s13034-020-00351-5.
We recently adapted the published National Institute for Health and Care Excellence (NICE) Attention deficit hyperactivity disorder (ADHD) diagnosis and management guideline to the Saudi Arabian context. It has been postulated that adaptation of evidence-based clinical practice guidelines to the local healthcare context rather than de-novo development will improve their adoption and implementation without imposing a significant burden on resources. The objective of this paper is to describe the adaptation process methodology utilized for the generation of the first national guideline for management of people with ADHD in Saudi Arabia.
We used the KSU-Modified-ADAPTE methodology for the guideline adaptation process. We describe the full process in detail including the three phases of set-up, adaptation, and finalization. The process was conducted by a multidisciplinary guideline adaptation group in addition to an external review for the clinical content and methodology.
The group adapted ten main categories of recommendations from one source CPG (NICE). The recommendations include: (i) service organisation and training, (ii) recognition, identification and referral, (iii) diagnosis, (iv) support, (v) managing ADHD, (vi) dietary advice, (vii) medication, (viii) maintenance and monitoring, (ix) adherence to treatment, and (x) review of medication and discontinuation. Several implementation tools were compiled and developed to enhance implementability including a clinical algorithm, quality measures, coding system, medication tables, translations, patient information, and online resources.
The finalized clinical practice guideline provides healthcare providers with applicable evidence-based guidance for the management of people with ADHD in Saudi Arabia. The project also demonstrated the effectiveness of KSU-Modified-ADAPTE, and emphasized the value of a collaborative clinical and methodological expert group for adaptation of national guidelines.
我们最近将已发布的英国国家卫生与临床优化研究所（NICE）注意力缺陷多动障碍（ADHD）诊断与管理指南进行了调整，以适用于沙特阿拉伯的情况。据推测，将循证临床实践指南调整适用于当地医疗环境，而非重新制定，将提高其采用率和实施效果，同时不会给资源带来重大负担。本文的目的是描述用于制定沙特阿拉伯首部ADHD患者管理国家指南的调整过程方法。
我们在指南调整过程中使用了KSU修改版ADAPTE方法。我们详细描述了整个过程，包括准备、调整和定稿三个阶段。该过程由一个多学科指南调整小组进行，此外还对临床内容和方法进行了外部审查。
该小组从一个来源的临床实践指南（NICE）中调整了十大类建议。这些建议包括：（i）服务组织与培训，（ii）识别、鉴定与转诊，（iii）诊断，（iv）支持，（v）ADHD管理，（vi）饮食建议，（vii）药物治疗，（viii）维持与监测，（ix）治疗依从性，以及（x）药物审查与停药。编制并开发了几种实施工具以提高可实施性，包括临床算法、质量指标、编码系统、药物表、翻译、患者信息和在线资源。
最终确定的临床实践指南为沙特阿拉伯的医疗服务提供者提供了适用于ADHD患者管理的循证指导。该项目还证明了KSU修改版ADAPTE的有效性，并强调了临床和方法学专家合作小组在调整国家指南方面的价值。
