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Gaps in COPD Guidelines of Low- and Middle-Income Countries: A Systematic Scoping Review

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dc.contributor.author Tabyshova, Aizhamal
dc.contributor.author Hurst, John R.
dc.contributor.author Soriano, Joan B.
dc.contributor.author Checkley, William
dc.contributor.author Wan Chun Huang, Erick
dc.contributor.author Trofor, Antigona C.
dc.contributor.author Flores Flores, Oscar
dc.contributor.author Alupo, Patricia
dc.contributor.author Gianella, Gonzalo
dc.contributor.author Ferdous, Tarana
dc.contributor.author Meharg, David
dc.contributor.author Alison, Jennifer
dc.contributor.author Correia de Sousa, Jaime
dc.contributor.author Postma, Maarten J.
dc.contributor.author Chavannes, Niels H.
dc.contributor.author van Boven, Job F. M.
dc.date.accessioned 2021-04-13T20:51:00Z
dc.date.available 2021-04-13T20:51:00Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9147
dc.description.abstract BACKGROUND: Guidelines are critical for facilitating cost-effective COPD care. Development and implementation in low-and middle-income countries (LMICs) is challenging. To guide future strategy, an overview of current global COPD guidelines is required. RESEARCH QUESTION: We systematically reviewed national COPD guidelines, focusing on worldwide availability and identification of potential development, content, context, and quality gaps that may hamper effective implementation. STUDY DESIGN AND METHODS: Scoping review of national COPD management guidelines. We assessed: (1) global guideline coverage; (2) guideline information (authors, target audience, dissemination plans); (3) content (prevention, diagnosis, treatments); (4) ethical, legal, and socio-economic aspects; and (5) compliance with the eight Institute of Medicine (IOM) guideline standards. LMICs guidelines were compared with those from high-income countries (HICs). RESULTS: Of the 61 national COPD guidelines identified, 30 were from LMICs. Guidelines did not cover 1.93 billion (30.2%) people living in LMICs, whereas only 0.02 billion (1.9%) in HICs were without national guidelines. Compared with HICs, LMIC guidelines targeted fewer health-care professional groups and less often addressed case finding and co-morbidities. More than 90% of all guidelines included smoking cessation advice. Air pollution reduction strategies were less frequently mentioned in both LMICs (47%) and HICs (42%). LMIC guidelines fulfilled on average 3.37 (42%) of IOM standards, compared with 5.29 (66%) in HICs (P < .05). LMICs scored significantly lower compared with HICs regarding conflicts of interest management, updates, articulation of recommendations, and funding transparency (all, P < .05). INTERPRETATION: Several development, content, context, and quality gaps exist in COPD guidelines from LMICs that may hamper effective implementation. Overall, COPD guidelines in LMICs should be more widely available and should be transparently developed and updated. Guidelines may be further enhanced by better inclusion of local risk factors, case findings, and co-morbidity management, preferably tailored to available financial and staff resources. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Chest
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject consensus en_US
dc.subject chronic obstructive en_US
dc.subject developing countries en_US
dc.subject pulmonary disease en_US
dc.subject reference standards en_US
dc.title Gaps in COPD Guidelines of Low- and Middle-Income Countries: A Systematic Scoping Review en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1016/j.chest.2020.09.260
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.09
dc.relation.issn 1931-3543


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