Journal of Child Psychology and Psychiatry vol:55 issue:1 pages:3-21
Context-specific evidence-based guidelines on how to prevent and treat substance misuse among adolescents are currently lacking in many countries. Due to the time consuming nature of de novo guideline development, the ADAPTE collaboration introduced a methodology to adapt existing guidelines to a local context. An important step in this method is a systematic review to identify relevant high-quality evidence-based guidelines. We describe the results of this step for the development of guidelines on adolescent alcohol and drug misuse in Belgium.
Rigorous systematic review methodology was used. We searched electronic databases, websites of relevant organizations, and reference lists of key publications. Experts in the field were also contacted. We included Dutch, English, French or German evidence-based practice guidelines from 2006 or later on the prevention, screening, assessment or treatment of alcohol or illicit drug misuse in persons aged 12 to 18 years. Two independent reviewers assessed the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument.
This systematic review identified 32 relevant evidence-based guidelines on substance misuse among adolescents. Nine guidelines were judged to be of high quality; of which four had recommendations specifically on adolescents: one on school-based prevention, one on substance misuse prevention in vulnerable young people and two on alcohol misuse with specific sections for the adolescent population. There were few commonalities since guidelines focused on different target groups, professional disciplines and type and level of substance misuse. Evidence to support the recommendations was sparse, and many recommendations were based on expert consensus or on studies among adults. Also, the link between evidence and recommendations was often unclear.
There are a substantial number of guidelines addressing substance misuse in adolescents. However, only four high-quality guidelines included recommendations specific for adolescents. The current level of evidence that underpins the recommendations in these high-quality guidelines is low.