Assessment of the methodological quality of a medication administration protocol using the AGREE II instrument
DOI:
https://doi.org/10.30968/jhphs.2026.171.1418Abstract
Objective: To evaluate the methodological quality of the protocol entitled ‘Recommendations for Inhalation Technique with Pressurized Metered-Dose Inhalers in Invasive Mechanical Ventilation’ Methods: This is a descriptive study evaluating methodological quality using the international instrument Appraisal of Guidelines for Research and Evaluation II (AGREE II). Six domains of the protocol were assessed: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. These domains are organized into 23 items and rated on a 7-point Likert scale. Eligible members for the evaluation panel included PhD-level professors in the fields of medicine, pharmacy, nursing and physiotherapy with prior experience in intensive care, health technology assessment, epidemiology, or teaching and research. The quality score (QS), intraclass correlation coefficient (ICC) and Pearson’s coefficient of variation (PCV) were calculated for each domain, as well as the overall quality score of the protocol. Results: Three PhD-level professors from the fields of medicine, pharmacy, and physiotherapy evaluated the protocol. Five domains achieved quality scores above 90%. The “stakeholder involvement” domain scored 68.52%, prompting revisions to the protocol to better align it with quality standards. The overall quality score was 100%. All evaluators recommended the protocol for clinical practice. Conclusion: After undergoing an extensive evaluation process, the protocol for the administration of inhaled medication during mechanical ventilation was published, achieving satisfactory scores in terms of its methodological quality. Although the AGREE II instrument is less commonly used to assess protocols and guidelines focused on medication use, it was applied in this study, demonstrating its feasibility for evaluating documents within this scope.
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