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How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project

In Brazil, there have been some initiatives to improve the development of Ministry of Health clinical protocols and therapeutic guidelines (PCDTs in Portuguese, and clinical practice guidelines—CPGs, in English) and their implementation so that best practices can be disseminated and adopted at multi...

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Autores principales: Pereira, Viviane Cássia, Silva, Sarah Nascimento, Vidal, Ávila Teixeira, Lins, Gustavo Veiga e, Barreto, Jorge Otávio Maia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035473/
https://www.ncbi.nlm.nih.gov/pubmed/36959620
http://dx.doi.org/10.1186/s12961-023-00966-y
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author Pereira, Viviane Cássia
Silva, Sarah Nascimento
Vidal, Ávila Teixeira
Lins, Gustavo Veiga e
Barreto, Jorge Otávio Maia
author_facet Pereira, Viviane Cássia
Silva, Sarah Nascimento
Vidal, Ávila Teixeira
Lins, Gustavo Veiga e
Barreto, Jorge Otávio Maia
author_sort Pereira, Viviane Cássia
collection PubMed
description In Brazil, there have been some initiatives to improve the development of Ministry of Health clinical protocols and therapeutic guidelines (PCDTs in Portuguese, and clinical practice guidelines—CPGs, in English) and their implementation so that best practices can be disseminated and adopted at multiple levels of health systems. One of the initiatives was to conduct a pilot project to improve the format of these CPGs. The objective of this article is to present the processes and results of the pilot project, including the development of a new standardized format for CPGs to promote national dissemination and uptake. The pilot project was designed in three phases: identification and selection of strategies to effectively implement clinical practice guidelines, definition of the ideal characteristics for the format of CPGs, and development and implementation of the new format. Initially, an overview of systematic reviews was conducted to map the global evidence on the effectiveness of dissemination and implementation strategies of CPGs. Among the most effective interventions, a low-cost strategy was selected to improve the format of CPGs, namely a full format and a short format. The two formats were evaluated for usefulness and acceptability by professionals who use or develop CPGs, and after several reiterations, the formats were finalized, considering the progression of care (from diagnosis of the disease to treatment, including specific technologies indicated in each stage of the disease). Related to the technical aspects, the visual presentation of the CPGs was improved, ensuring that key information was easily identified for decision-making by end users. The initial phase of implementation involved 33 clinical conditions, equating to approximately 20% of published CPGs. It is anticipated that disseminating the CPGs in the new formats will promote the accessibility of information and implementation of standardized CPGs by health professionals in the public health sector (servicing more than 210 million Brazilians). Further research should be considered to determine the impact of the use of the new CPGs formats, contributing to the knowledge base related to the implementation of guidelines in Brazil and internationally. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12961-023-00966-y.
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spelling pubmed-100354732023-03-23 How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project Pereira, Viviane Cássia Silva, Sarah Nascimento Vidal, Ávila Teixeira Lins, Gustavo Veiga e Barreto, Jorge Otávio Maia Health Res Policy Syst Research In Brazil, there have been some initiatives to improve the development of Ministry of Health clinical protocols and therapeutic guidelines (PCDTs in Portuguese, and clinical practice guidelines—CPGs, in English) and their implementation so that best practices can be disseminated and adopted at multiple levels of health systems. One of the initiatives was to conduct a pilot project to improve the format of these CPGs. The objective of this article is to present the processes and results of the pilot project, including the development of a new standardized format for CPGs to promote national dissemination and uptake. The pilot project was designed in three phases: identification and selection of strategies to effectively implement clinical practice guidelines, definition of the ideal characteristics for the format of CPGs, and development and implementation of the new format. Initially, an overview of systematic reviews was conducted to map the global evidence on the effectiveness of dissemination and implementation strategies of CPGs. Among the most effective interventions, a low-cost strategy was selected to improve the format of CPGs, namely a full format and a short format. The two formats were evaluated for usefulness and acceptability by professionals who use or develop CPGs, and after several reiterations, the formats were finalized, considering the progression of care (from diagnosis of the disease to treatment, including specific technologies indicated in each stage of the disease). Related to the technical aspects, the visual presentation of the CPGs was improved, ensuring that key information was easily identified for decision-making by end users. The initial phase of implementation involved 33 clinical conditions, equating to approximately 20% of published CPGs. It is anticipated that disseminating the CPGs in the new formats will promote the accessibility of information and implementation of standardized CPGs by health professionals in the public health sector (servicing more than 210 million Brazilians). Further research should be considered to determine the impact of the use of the new CPGs formats, contributing to the knowledge base related to the implementation of guidelines in Brazil and internationally. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12961-023-00966-y. BioMed Central 2023-03-23 /pmc/articles/PMC10035473/ /pubmed/36959620 http://dx.doi.org/10.1186/s12961-023-00966-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Pereira, Viviane Cássia
Silva, Sarah Nascimento
Vidal, Ávila Teixeira
Lins, Gustavo Veiga e
Barreto, Jorge Otávio Maia
How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title_full How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title_fullStr How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title_full_unstemmed How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title_short How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System? Report of a pilot project
title_sort how to improve the dissemination of clinical practice guidelines in the brazilian unified health system? report of a pilot project
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035473/
https://www.ncbi.nlm.nih.gov/pubmed/36959620
http://dx.doi.org/10.1186/s12961-023-00966-y
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