Mexican clinical practice guideline for diagnosis and treatment of chronic obstructive pulmonary disease

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of the death in Mexico and worldwide. In recent years, great progress has been achieved in its management and treatment, which also entails greater complexity. In Mexico, the development of clinical practice guidelines (CPG) under international standards is essential to stablish recommendations at all levels of care. Objectives: This Clinical Practice Guideline provides systematically developed clinical recommendations to assist clinical decision makers involved in the management of patients with COPD. Material and methods: This document was developed by the Mexican Respiratory Society in compliance with international standards described by the IOM (Institute of Medicine). An interdisciplinary Guideline Development Group (GDG), considering experts in respiratory medicine and methodologists with experience in systematic reviews of the literature and CPG development. GDG agreed the scope of the guideline, the clinical questions list and made the critical appraisal of the current evidence with validated tools. We use ADAPTE approach to conduct the cross-cultural adaptation of several international guidelines in order to provide clinical recommendations suitable to our country. Results: The GDG agreed on 40 clinically relevant questions in order to develop clinical recommendations. The scientific evidence that answered each of these clinical questions was identified and critically evaluated, before being incorporated into the body of evidence of the guideline. The GDG agreed by means of the formal consensus technique modified panel Delphi, the final drafting of the clinical recommendations. Recommendations address important clinical gaps regarding diagnoses and treatment of COPD. Conclusion: This CPG intends to provide clinical recommendations for the diagnosis and management of patients with Chronic Obstructive Pulmonary Disease and to assist in the shared decision-making process. The GDG hopes that this guide will contribute to improve the quality of clinical care in patients with this illness.