Guideline 74: The management of harmful drinking and alcohol dependence in primary care

The management of harmful drinking and alcohol dependence in primary care
Section 9: Development of the guideline

9.1 Introduction

SIGN is a collaborative network of clinicians, other healthcare professionals, and patient organisations, funded by NHS Quality Improvement Scotland. SIGN guidelines are developed by multidisciplinary groups of practising clinicians using a standard methodology based on a systematic review of the evidence. Further details about SIGN and the guideline development methodology are contained in “SIGN 50: A Guideline Developer’s Handbook”, available at www.sign.ac.uk

9.2 The guideline development group

Dr Jonathan Chick (Chair)	Consultant Psychiatrist, Alcohol Problems Clinic, Royal Edinburgh Hospital
Dr Carole Allan	Clinical Psychologist, Gartnavel Royal Hospital,Glasgow
Dr Bahar Ashraf-Uzzaman	General Practitioner, Airdrie, Lanarkshire
Mr Ken Barrie	Director, Centre for Alcohol and Drug Studies, University of Paisley
Mr Richard Brooks	Health Economist, Strathclyde University, Glasgow
Mr Robert Burns	Lay Representative
Professor Peter Brunt	Consultant Physician, Aberdeen Royal Infirmary
Ms Francesca Chappell	Information Officer, SIGN
Dr Alan Clubb	General Practitioner, Musselburgh
Dr Alex Crawford	Director, Renfrew Council on Alcohol, Paisley
Ms Marie Egan	Community Psychiatric Charge Nurse, Invergordon, Ross-shire
Dr Sandy Elder	Consultant Occupational Physician, Lanarkshire
Dr Ali El-Ghorr	Programme Manager, SIGN
Ms Fiona Everett	Nurse Lecturer, Bell College, Hamilton
Dr Ciara Flanigan	Consultant Psychiatrist, Leverndale Hospital, Glasgow
Sister Michelle Jamieson	Senior Nurse, Accident and Emergency Department, Royal Infirmary of Edinburgh
Ms Alison MacKinnon	Pharmacist, Sunnyside Royal Hospital, Angus
Dr Claire McIntosh	Specialist Registrar, Alcohol Problems Clinic, Royal Edinburgh Hospital
Mr David Pattison	Health Promotion Manager, Forth Valley NHS Board, Stirling
Mr Walter Simpson	Lay Representative
Dr Richard Watson	General Practitioner, Glasgow

The membership of the guideline development group was confirmed following consultation with the member organisations of SIGN. Declarations of interests were made by all members of the guideline development group. Further details are available from the SIGN Executive. Guideline development and literature review expertise, support, and facilitation were provided by the SIGN Executive.

9.3 Systematic literature review

The evidence base for this guideline was synthesised in accordance with SIGN methodology. A systematic review of the literature was carried out using an explicit search strategy devised by a SIGN Information Officer. Databases searched include Medline, Embase, Healthstar, Cinahl, PsychINFO, Alcohol and Alcoholism, and the Cochrane Library. The year range covered was 1995-2001. Internet searches were carried out on various websites including the New Zealand Guidelines Programme, the UK Health Technology Assessment programme, the NIAAA Alcohol and Alcohol Problems Science Database (ETOH), and the US National Guidelines Clearinghouse. The Medline version of the main search strategies can be found on the SIGN website, in the section covering supplementary guideline material. The main searches were supplemented by material identified by individual members of the development group. All selected papers were evaluated by two members of the group using standard SIGN methodological checklists before conclusions were considered as evidence.

9.4 Consultation and peer review

9.4.1 NATIONAL OPEN MEETING

A national open meeting is the main consultative phase of SIGN guideline development, at which the guideline development group presents its draft recommendations for the first time. The national open meeting for this guideline was held on 29 April 2002 and was attended by around 150 representatives of all the key specialties relevant to the guideline. The draft guideline was also available on the SIGN website for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline.

9.4.2 SPECIALIST REVIEW

The guideline was also reviewed in draft form by a panel of independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. SIGN is very grateful to all of these experts for their contribution to this guideline.

Dr Peter Anderson	Public Health Consultant, Nijmegen, The Netherlands
Dr Alan Begg	General Practitioner, Montrose
Mr Graham Bell	Lay Representative
Mr Colin Bennie	Community Alcohol Services Manager, Bannockburn Hospital
Reverend Professor Chris Cook	Professor of the Psychiatry of Alcohol Misuse, University of Kent, Canterbury
Mr Mike Craigie	Lay Representative
Dr Lesley Graham	Programme Principal for Substance Misuse, Information and Statistics Division, Scottish Executive Health Department, Edinburgh
Professor Nick Heather	Director, Centre for Alcohol and Drug Studies, Newcastle
Professor Ray Hodgson	Professor of Psychology, Lansdowne Hospital, Cardiff
Dr Kathy Long	General Practitioner, Airdrie
Dr Allan Merry	General Practitioner, Ardrossan
Dr Grahame Mitchell	General Practitioner, Aultbea
Dr Dorothy Moir	Director of Public Health, Lanarkshire NHS Board, Hamilton
Dr Marsha Morgan	Reader in Medicine and Honorary Consultant Physician, Royal Free and University College Medical School, London
Dr David Morrison	Consultant in Public Health Medicine, Greater Glasgow NHS Board, Glasgow
Dr Catriona Morton	General Practitioner, Edinburgh
Mrs Eileen Murray	Dietitian for Homelessness and Resettlement, Glasgow Primary Care Trust, Glasgow
Professor Jim Orford	Professor in Community Psychology, School of Psychology, University of Birmingham
Mrs Lorraine Park	Senior Occupational Therapist, Sunnyside Royal Hospital, Montrose
Professor David Peck	Area Clinical Psychologist, New Craigs Hospital, Inverness
Dr John Reid	General Practitioner, Alford
Ms Penny Richardson	Director, Edinburgh and Lothian Council on Alcohol
Dr Bruce Ritson	Chairman, Medical Council on Alcohol, Edinburgh
Dr Sheila Scott	Director of Health Planning, Royal Alexandra Hospital, Paisley
Dr James Thompson	General Practitioner, Airdrie
Dr Donald Thomson	General Practitioner and Senior Lecturer, Community Health Sciences, University of Edinburgh
Dr Robin Touquet	Consultant in Accident and Emergency, St Mary’s Hospital, London
Ms Catherine Tully	Pharmacist, Parkland Hospital, Glasgow
Professor Hazel Watson	Assistant Head of Department of Nursing, School of Nursing, Midwifery and Community Health, Glasgow Caledonian University
Dr Barbara West	General Practitioner, Glasgow

9.4.3 SIGN EDITORIAL GROUP

As a final quality control check, the guideline is reviewed by an Editorial Group comprising the relevant specialty representatives on SIGN Council to ensure that the specialist reviewers’ comments have been addressed adequately and that any risk of bias in the guideline development process as a whole has been minimised. The Editorial Group for this guideline was as follows:

Dr David Alexander	Scottish General Practice Committee
Dr Keith Brown	Royal College of Psychiatrists
Professor Gordon Lowe	Chair of SIGN
Dr Lesley Macdonald	Faculty of Public Health Medicine
Dr Safia Qureshi	SIGN Programme Director
Dr Sara Twaddle	Director of SIGN
Dr Bernice West	National Nursing, Midwifery, Health Visiting Advisory Committee

Each member of the guideline development group then approved the final guideline for publication.

9.5 Acknowledgements

Dr Roch Cantwell	Senior Lecturer in Psychiatry, Glasgow University
Dr Brian Scott	General Practitioner, Glasgow
Ms Joanne Topalian	SIGN Programme Manager/Patient Project Manager