Research Library

Open Access | CC BY 4.0 | |

Authors:

1. Fahad A Bashiri
2. Turki H Albatti
3. Muddathir H Hamad
4. Haya F Al-Joudi
5. Hadeel F Daghash
6. Saleh M Al-Salehi
7. Jeremy L Varnham
8. Fatima Alhaidar
9. Omar Almodayfer
10. Abdulkarim Alhossein
11. Hesham Aldhalaan
12. Yasser A Ad-Dab’bagh
13. Nouf Al Backer
14. Waleed Altwaijri
15. Khalid Alburikan
16. Maysaa W Buraik
17. Mohammad Ghaziuddin
18. Michael J Nester
19. Hayfaa A Wahabi
20. Samia Alhabib
21. Amr A Jamal
22. Yasser S Amer

Child and Adolescent Psychiatry and Mental Health

10.1186/s13034-020-00351-5

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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Note: This study was conducted as part of the Saudi ADHD Society’s unified ADHD Clinical Practice Guidelines Project, strategic project #7.2 for the period 2017-2019. The project received approval from the Ministry of Labor and Social Development (No. 52476) on 5/8/1438. The project is entirely funded by the Saudi ADHD Society. No funding was received from any pharmaceutical or industrial company.

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Keywords

Practice guideline, Adaptation, Evidence-based medicine, ADHD, Attention deficit hyperactivity disorder, Mental health, Saudi Arabia, Eastern mediterranean region, Diagnosis, Treatment, CPG

Citation

Bashiri, F.A., Albatti, T.H., Hamad, M.H., Al-Joudi, H.F., Daghash, H.F., Al-Salehi, S.M., Varnham, J.L., Alhaidar, F., Almodayfer, O., Alhossein, A., Aldhalaan, H., Ad-Dab'bagh, Y.A., Backer, N., Altwaijri, W., Alburikan, K., Buraik, M.W., Ghaziuddin, M., Nester, M.J., Wahabi, H.A., Alhabib, S., … Amer, Y.S. (2021). Adapting evidence-based clinical practice guidelines for people with attention deficit hyperactivity disorder in Saudi Arabia: process and outputs of a national initiative. Child Adolesc Psychiatry Ment Health, 15(6), 1-16, doi: 10.1186/s13034-020-00351-5