gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Guidelines adaptation in the context of LMIC: a locally adapted guideline for the management of diabetes mellitus 2 (DM2) in Argentina

Meeting Abstract

  • M.E. Esandi - Instituto de Investigaciones Epidemiologicas - Academia Nacional de Medicina, Buenos Aires, Argentina
  • M. De Luca - Instituto de Investigaciones Epidemiologicas - Academia Nacional de Medicina, Buenos Aires, Argentina
  • Z. Ortiz - Instituto de Investigaciones Epidemiologicas - Academia Nacional de Medicina, Buenos Aires, Argentina
  • E. Chapman - Instituto de Investigaciones Epidemiologicas - Academia Nacional de Medicina, Buenos Aires, Argentina
  • F. Zambon - Ministerio de Salud de la Nación, Buenos Aires, Argentina
  • S. Laspiur - Ministerio de Salud de la Nación, Buenos Aires, Argentina

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO75

DOI: 10.3205/12gin107, URN: urn:nbn:de:0183-12gin1072

Veröffentlicht: 10. Juli 2012

© 2012 Esandi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background/Purpose: Resources for “de novo” elaboration of high quality guidelines in Low Middle Income Countries (LMIC) are scarce. Local adaptation processes should involve stakeholders and be systematic and transparent.

Objectives: to report the results of applying an evidence-based framework for local adaptation of existing guidelines for the management of DM2 in Argentina.

Methods: a stepwise approach was used:

1.
selection of a priority topic;
2.
formulation and prioritization of structured clinical questions (CQ);
3.
systematic searching of existing CPG and systematic reviews (SR);
4.
quality assessment;
5.
development of the CPG-SR table;
6.
adaptation of recommendations upon established criteria;
7.
external validation;
8.
endorsement by official authorities.

Results: An interdisciplinary team, constituted by representatives of the National Academy of Medicine (NAM), Ministry of Health (MoH), scientific societies, hospitals and social security organizations, defined the scope and 26 CQ. 133 CPG and 106 SR were found but only 3 and 38, respectively, had the minimum quality criteria to be included in the adaptation process. 24 CQ were totally (22 CQ) or partially (2 CQ) answered by CPG and SR; only 2 required “de novo” elaboration, as no evidence was found.

Discussion: This evidence-based and locally adapted CPG was the first one that was successfully produced by a joint effort of the MoH, the NAM and representatives of other Argentine institutions.

Implications for guideline developers/users: First initiatives of systematic guidelines adaptation in the context of LMIC imply not only a methodological change, but mainly a cultural change that requires time, commitment and financing.