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Background Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations. Objective The study objective is to identify and critically appraise the quality of existing clinical practice guidelines for tobacco cessation. Setting The study occurred between collaborative academic institutions located in Qatar and New Zealand. Methods A systematic literature search was performed for the period 2006–2018 through the following databases: PubMed, EMBASE, CINAHL, ISI Web of Science, Scopus, National Guideline Clearing House, Campbell Library, Health System Evidence, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, PROSPERO, and Google Scholar. Relevant professional societies’ and health agencies’ websites were also searched. Two reviewers independently extracted and assessed guidelines’ quality using Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Main outcome measure Standardized domain scores according to the AGREE II instrument. Results 7741 hits were identified. After removing duplicates and screening, 24 guidelines were included. Highest guideline quality was for National Institute for Health and Care Excellence (NICE) guideline with an overall ranking score of 87.56% and least quality was for Japanese Circulation Society Joint Working Group with an overall score of 29.34%. Domain 4 of AGREE II (clarity of presentation) had the highest average quality score (70.95%), while the lowest average quality scores were for Domain 2 (Rigour of Development) (50.21%) and Domain 5 (Applicability) (45.05%). Conclusion Seven guidelines were judged to be of high quality (overall score of ≥ 70%). Future guidelines for tobacco dependence treatment should use rigorous methods of development and provide applicable recommendations. Other Information Published in: International Journal of Clinical Pharmacy License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s11096-020-01110-4

Background: In Qatar, 86% of patients with diabetes are uncontrolled. Given that nonadherence to oral drug therapy and psychological insulin resistance are a common phenomenon, one could postulate that patients may not be taking their medications as prescribed. Therefore, the primary aim of this study was to explore the barriers to medication adherence among patients with uncontrolled diabetes in a primary healthcare setting from the perspectives of the patients and their healthcare providers. Methodology: This study was divided into two phases: patients’ perspective using a mixed-method approach, and healthcare providers’ perspective on the issue using qualitative approach. Patients with uncontrolled diabetes responded to a questionnaire followed by one-to-one in-depth interviews. On the other hand, healthcare providers directly involved in the care of patients with diabetes participated in semi-structured one-to-one interviews. Descriptive and inferential analyses were used for quantitative data, while thematic analysis was used for qualitative data. Finally, data from the two phases were triangulated in interpretation. Results: Overall, 74% of the sample was nonadherent to diabetes medications. The quantitative results indicated that sociodemographic characteristics did not significantly influence medication adherence, except living with family. The majority of pre-determined barriers to medication adherence were reported by nonadherent patients and the most commonly reported barrier was forgetfulness. In addition, significantly higher levels of nonadherence were found among patients who were younger than 65 years and those who were illiterate. Qualitative data revealed five different themes from both patients’ and healthcare providers’ perspectives: (1) patient-related aspects, such as patient’s characteristics, perceptions, attitude and knowledge; (2) patient-provider interaction, which involved communication and interaction time; (3) appointment system and follow up, which was highly varied among patients despite their similar needs; (4) influence of other individuals including family support and social stigma and; (5) traveling and the use of traditional medicine by the patient in home country in an effort to cure the disease. Conclusion: Despite the different perspectives related to medication nonadherence, similar themes emerged from patients and their respective healthcare providers. The identified barriers warrant concerted efforts and series of interventions which should be initiated in a step-wise approach in order to improve medication adherence and overall healthcare outcomes.