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Multiple sclerosis clinical practice guidelines provide few complementary and alternative medicine recommendations: A
Jeremy Y Ng1, Vanessa Kishimoto1
1Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
Few clinical practice guidelines (CPGs) offer recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS) management. This study assessed the quality of available CAM guidance in MS CPGs, finding limited and variable recommendations.
Area of Science:
- Neurology
- Integrative Medicine
- Evidence-Based Practice
Background:
- Complementary and alternative medicine (CAM) is frequently used by individuals with multiple sclerosis (MS).
- The extent and quality of CAM recommendations within MS clinical practice guidelines (CPGs) remain largely unexamined.
- Guidance for healthcare professionals and patients on CAM use in MS is limited.
Purpose of the Study:
- To determine the prevalence of CAM mentions in MS CPGs.
- To evaluate the quality of CAM recommendations within these guidelines.
Main Methods:
- A systematic review identified MS CPGs published between 2008 and 2018.
- Databases searched included MEDLINE, EMBASE, and CINAHL, alongside specific guideline repositories.
- The Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument assessed the quality of eligible CPGs with CAM recommendations.
Main Results:
- Of 204 unique results, only six CPGs mentioned CAM, and four provided specific recommendations.
- Quality assessment revealed variability across domains, with clarity of presentation and scope/purpose scoring highest.
- While three of four CPGs were recommended, one required modifications, indicating inconsistent guideline quality.
Conclusions:
- CAM recommendations are present in a minority of eligible MS CPGs.
- High-scoring CPGs can facilitate informed discussions between patients and healthcare providers regarding CAM therapies.
- There is a significant gap in comprehensive CPGs to guide clinicians and patients on CAM use for MS.
