Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVE: To assess the reporting of monitoring recommendations in guidelines on the prevention and treatment of cardiovascular disease. DATA SOURCES: Medline, Trip database, National Guideline Clearinghouse, and databases containing guidelines published from January 2002 to February 2010. Data selection Three major risk factors for cardiovascular disease: cholesterol level, smoking, and hypertension. The primary outcome was the frequency with which the guidelines dealt with monitoring of risk factors. Secondary outcomes were completeness of monitoring recommendations, defined by the presence of what to monitor, when to monitor, what to do if the targets or variables were not met, and the reported level or strength of the evidence. RESULTS: 117 guidelines were identified, 84 (72%) of which contained a section on lipids. Of those guidelines with a section on lipids, 53% (n = 44) provided no information or specific recommendations on what to monitor, 51% (n = 43) provided no information on when to monitor, and 64% (n = 54) provided no guidance on what to do if the target was out of range. Guidelines for hypertension (n = 79) and smoking (n = 65) were little better, with 63% (n = 50) and 54% (n = 35), respectively, providing no recommendation for what to monitor. The number of guidelines that explicitly referenced the level of evidence for monitoring was low, with most of the recommendations based on weak levels of evidence. CONCLUSION: Many guidelines for cardiovascular disease do not report clearly what to monitor and what to do if a change is detected. If no evidence is available to support a specific monitoring schedule, this should be explicit in the guideline, with a description of the new research that would fill the gap.

Original publication

DOI

10.1136/bmj.d1289

Type

Journal article

Journal

BMJ

Publication Date

14/03/2011

Volume

342

Keywords

Cardiovascular Diseases, Humans, Hypertension, Lipids, Practice Guidelines as Topic, Risk Factors, Smoking Prevention