A Systematic Review of Clinical Practice Guidelines for Neonatal Abstinence Syndrome.

clinical practice guidelines development neonatal abstinence syndrome neonatal opioid withdrawal syndrome prenatal opioid exposure

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
13 Oct 2023
Historique:
received: 05 09 2023
revised: 09 10 2023
accepted: 12 10 2023
medline: 28 10 2023
pubmed: 28 10 2023
entrez: 28 10 2023
Statut: epublish

Résumé

The prevalence of neonatal abstinence syndrome is increasing, but the number and quality of clinical practice guidelines available are unknown. This systematic review aimed to identify, appraise and evaluate clinical practice guidelines for neonatal abstinence syndrome. A systematic search of databases and the grey literature was conducted between 1 June and 1 July 2022. Full-text guidelines published by national or state-wide institutions were included. The recommendations from each guideline were extracted. The AGREE-II instrument was used to assess guideline quality. Sufficient-quality scores were defined as >60 and good-quality scores were >80 for each domain of AGREE-II. A total of 1703 records were identified, and 22 guidelines from the United States, Australia, Canada and the United Kingdom, published between 2012 to 2021, were included. The quality scores were low, with median scores of 37/100 for stakeholder involvement, 33/100 for methodology, 34/100 for applicability and 0 for editorial independence. Scope and purpose scored 72/100, and presentation scored 85/100. Sixteen (73%) guidelines did not meet the cut-offs for clinical use. Many guidelines were of insufficient quality to guide clinical practice for neonatal abstinence syndrome. This emphasises the need for high-quality studies to inform clinical practice guidelines, improve care and reduce the risk of poor outcomes in these high-risk infants.

Sections du résumé

BACKGROUND BACKGROUND
The prevalence of neonatal abstinence syndrome is increasing, but the number and quality of clinical practice guidelines available are unknown. This systematic review aimed to identify, appraise and evaluate clinical practice guidelines for neonatal abstinence syndrome.
METHODS METHODS
A systematic search of databases and the grey literature was conducted between 1 June and 1 July 2022. Full-text guidelines published by national or state-wide institutions were included. The recommendations from each guideline were extracted. The AGREE-II instrument was used to assess guideline quality. Sufficient-quality scores were defined as >60 and good-quality scores were >80 for each domain of AGREE-II.
RESULTS RESULTS
A total of 1703 records were identified, and 22 guidelines from the United States, Australia, Canada and the United Kingdom, published between 2012 to 2021, were included. The quality scores were low, with median scores of 37/100 for stakeholder involvement, 33/100 for methodology, 34/100 for applicability and 0 for editorial independence. Scope and purpose scored 72/100, and presentation scored 85/100. Sixteen (73%) guidelines did not meet the cut-offs for clinical use.
CONCLUSION CONCLUSIONS
Many guidelines were of insufficient quality to guide clinical practice for neonatal abstinence syndrome. This emphasises the need for high-quality studies to inform clinical practice guidelines, improve care and reduce the risk of poor outcomes in these high-risk infants.

Identifiants

pubmed: 37892348
pii: children10101685
doi: 10.3390/children10101685
pmc: PMC10605060
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Zoe Wei (Z)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

Yasmin Gilbert (Y)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
Prince of Wales Hospital, Barker Street, Randwick, Sydney, NSW 2031, Australia.

Arabhi Thananjeyan (A)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

James Cope (J)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

Rachael L Morton (RL)

National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, 92-94 Parramatta Road, Camperdown, Sydney, NSW 2006, Australia.

Annie Li (A)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

Cecile T Pham (CT)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

Meredith Ward (M)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
Department of Newborn Care, The Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW 2031, Australia.

Ju Lee Oei (JL)

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
Department of Newborn Care, The Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW 2031, Australia.

Classifications MeSH