A Clinical Practice Guideline Summary for Pharmacological Management of Adults with Major Depressive Disorder in Malaysia

Abstract

Background: Clinical Practice Guidelines (CPGs) are systematically developed statements to assist practitioners and patients with appropriate health care for specific clinical circumstances. However, evidence suggests that the uptake of these recommendations in routine care is still limited, particularly in resource-constrained countries. Objectives: This article aimed to (1) identify current CPGs for the pharmacological management of MDD that address and are compatible with the needs of Malaysian psychiatrists (2) collate and summarise these CPG recommendations to produce a more culturally sensitive and end-user friendly guideline summary. Materials and Methods: A multidisciplinary steering group followed an adapted development approach that included; (1) searching for guidelines on the pharmacological management of adults with depression, (2) screening them for relevant recommendations, (3) critical appraising these guidelines, and (4) extracting the required information. A panel of experts then reviewed the developed guideline summary. Results: Six potentially relevant guidelines for the pharmacological management of depression in adults were identified. The developed summary included a decision algorithm to guide the selection of antidepressant therapy based on clinical factors, potential drug-drug interaction, tolerability, and cost of the medications. The review panel considered the summary recommendations easy to use and had the potential for uptake by busy psychiatrists. Conclusion: A CPG summary for the pharmacological management of depression was developed that focuses on evidence-based, contextually relevant recommendations that are feasible for implementation within the local healthcare settings in Malaysia. Practical Implications: The developed guideline summary has the potential to enhance the implementation of evidence-based practice in the management of Major Depressive Disorder within the Malaysian context.