Critical Appraisal of Clinical Practice Guidelines for the Care of Patients with Multiple Sclerosis

Background: Evidence-based clinical practice guidelines (CPGs) are key instruments for enhancing care quality, standardizing health services, and improving clinical decision-making. Several international guidelines have been developed managing multiple sclerosis (MS), differing in comprehensiveness, consideration of care dimensions, methodological quality, and overall structure. This research aimed to critically appraise existing CPGs on MS care and identify the most appropriate options for adaptation within health systems in low- and middle-income countries. Methods: This guideline appraisal research was conducted during 2024–2025. A systematic search was performed in databases and clinical guideline repositories to identify relevant CPGs. Selected guidelines were evaluated by a panel of MS care specialists using the AGREE II instrument across six domains: scope and purpose, stakeholder involvement, Rigor of development, clarity of presentation, applicability, and editorial independence as well as two overall assessment criteria. Results: Of 28 identified guidelines, eight met the inclusion criteria and were appraised , while 20 were excluded due to issues with relevance, methodological quality, credibility, or lack of full-text accessibility. The appraisal revealed variability in the quality across the six domains, with significant differences in overall scores. Conclusion: The findings indicate that the existing MS care CPGs exhibit heterogeneity in structural and content quality. Based on AGREE II scores, two guidelines—including those from Malaysia and NICE—showed the highest quality and are recommended as foundation for adaptation within health systems in low- and middle-income countries. Developing a locally adapted guideline based on these results can improve nursing care quality, promote evidence-based decision-making, strengthen multidisciplinary coordination, and improve patient outcomes.