Best evidence for the prevention, treatment and management of acute mountain sickness based on the PIPOST framework

To summarize the best available evidence of the prevention and management of acute mountain sickness (AMS) in order to provide evidence-based guidance for clinical practice.

A top-down systematic search was performed using the‘6S’evidence model across such databases as UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Cochrane Library, PubMed, Excerpta Medica Database (EMbase), Web of Science (WoS), CNKI, and Wanfang, as well as websites of related professional societies (SinoMed). Literature that was published from the inception of databases to November 2025 was retrieved.

A total of 18 articles were retrieved, including 2 guidelines, 3 expert consensus statements, 3 clinical decision support resources, 3 Meta-analyses, 2 systematic reviews, and 5 randomized controlled trials. Finally, 27 evidence items were synthesized and categorized into 7 thematic domains: staged acclimatization, non-pharmacological prevention, pharmacological prevention, adjunctive prevention, non-pharmacological treatment, pharmacological treatment, and patient education.

This study has summarized the best evidence of AMS prevention and management. Healthcare professionals are recommended to optimize AMS management by taking into account the specific settings and characteristics of patients.