Arch Iran Med. June 2022;25(6):353-359 Guideline Adopting Clinical Practice Guidelines for Pharmacologic Management of Acute Spinal Cord Injury from a Developed World Context to a Developing Global Region Seyed Behnam Jazayeri, MD, MPH 1 ; Seyed Farzad Maroufi, MD, MPH 1,2 ; Zahra Ghodsi, PhD, Postdoctoral Fellow 1,3 ; Heshmatollah Ghawami, BSc, MA 4 ; Ahmad Pourrashidi, MD 5 ; Abbas Amirjamshidi, MD, MPH 5 ; Mojtaba Mojtahedzadeh, MD 5,6 ; Jalil Arabkheradmand, MD 7 ; Farzin Farahbakhsh, MD, MPH 8,1 ; Maryam Shabany, PhD, Postdoctoral Fellow 2,1 ; Morteza Faghih- Jouibari, MD 9 ; Michael G. Fehlings, MD PhD FRCSC FACS 10 ; Brian K. Kwon, MD, PhD, FRCSC 11,12 ; James S. Harrop, MD, MSHQS, FACS 13 ; Vafa Rahimi-Movaghar, MD 1,3,9,14,15,16* 1 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran 2 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran 3 Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 4 Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran 5 Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 6 Director of Fellowship Program in Clinical Pharmacy and Critical Care, Faculty of Pharmacy 7 Director, Defence Health Research C, Tehran, Iran 8 Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran 9 Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 10 University of Toronto Spine Program and Toronto Western Hospital, Toronto, Ontario, Canada 11 International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada 12 Department of Orthopaedics, Division of Spine, University of British Columbia, Vancouver, BC, Canada 13 Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA 14 Universal Scientific Education and Research Network (USERN), Tehran, Iran 15 Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran 16 Visiting Professor, Spine Program, University of Toronto, Toronto, Canada Received: June 19, 2021, Accepted: November 21, 2021, ePublished: June 1, 2022 Abstract Background: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients’ outcomes on the ability and knowledge of “individual” health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute spinal cord injury (SCI) using guideline adaptation methods. Methods: This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each suggestion and the triad of feasibility, acceptance and adoptability for the Iranian health-care context. Results: Two guidelines were included in the adaptation process. Based on high-quality of these guidelines and the feasibility and adoptability evaluation of the organizing committee, we decided to adopt the suggestion of both guidelines. Overall, seven suggestions were extracted from the source guidelines. Conclusion: This work provides a framework to apply guidelines for acute SCI to the developing regions of the world. Attempts should be made to implement these suggestions in order to improve the health outcomes of Iranian SCI patients. Keywords: Clinical practice guideline, Pharmacologic management, Spinal cord injury Cite this article as: Jazayeri SB, Maroufi SF, Ghodsi Z, Fellow P, Ghawami H, Pourrashidi A, et al. Adopting clinical practice guidelines for pharmacologic management of acute spinal cord injury from a developed world context to a developing global region. Arch Iran Med. 2022;25(6):353–359. doi: 10.34172/aim.2022.58 *Corresponding Author: Vafa Rahimi-Movaghar, MD, Professor of Neurosurgery, Director of Traumatic Spinal Cord Injury, NSCIR-IR Principal Investigator, Sina Trauma and Surgery Research Center, Sina Hospital, Hassan Abad Square, Imam Khomeini Avenue, Tehran, Iran. Visiting Professor, Spine Program, University of Toronto. Tel: + 1(226)919-8541, E-mail: v_rahimi@sina.tums.ac.ir, v_rahimi@yahoo.com 10.34172/aim.2022.58 doi ARCHIVES OF IRANIAN MEDICINE Introduction Spinal cord injury (SCI) is a devastating and long-lasting condition that harms the normal sensory, motor and autonomic functions of patients and has a significant worldwide health and social impact. 1 The annual health- care costs for someone with SCI are estimated to be up to six times higher than individual suffering from other chronic conditions. 2 The estimated lifetime direct costs for an individual injured at age 25 ranges on average from 1.1 to 3.5 million dollars based on the level and severity of injury. 3 Many of the secondary complications and deleterious consequences of SCIs are not only associated with the impact from the injury itself, but by also by challenges Open Access http://www.aimjournal.ir