EPA-0725 – Case Management Guideline Assessment Using the Agree Instrument: First Results in Portugal

Abstract

Introduction:

The use of best practice guidelines had an exponential growth in the last 15 years, including in mental health. However the dissemination and use of guidelines has not always been followed by the critical appraisal of the their quality, specially when translation and cultural adaptation for other countries is involved. To increase the odds that a guideline will generate a better practice, they must be evaluated and strategies to their improvement need to be developed.

Objectives:

This study aims to evaluate a clinical guideline used to implement a case management model in the Portuguese mental health services.

Methods:

The guideline was assessed by two health experts working in the field of evidence based practices implementation: one from the mental health field and one from the communicable diseases field. The assessment was made with the AGREE Instrument 2 (second Portuguese version). Scores were calculated according with the rules of the AGREE Collaboration Group, 2011. Results

The assessment of the guideline on case management for people with sever mental illness showed good scores on the domains 1-Scope and Purpose (72%) and 4-Clarity of Presentation (77%), medium score for the domain 5-Applicability (54%) and low scores in the domains 2- Stakeholder Involvement (41%) and 3-Rigour of Development (28%).

Conclusions:

Critical appraisal of guidelines is crucial for the development of best care. The identification of faulty domains in guidelines offers an opportunity to improve and to shape recommendations considering national and local needs. New guidelines can be organised by considering AGREE II dimensions.