Estrategias para la implementación de guías clínicas de trastornos comunes de salud mental / Clinical guideline implementation strategies for common mental health disorders

Introducción: Pese a que la producción de guías clínicas ha proliferado considerablemente, su aplicación en la práctica es baja y muchos organismos no implementan las guías que producen. El objetivo de este estudio es sintetizar y describir elementos clave de las estrategias y recursos diseñados por el National Institute for Health and Care Excellence para la implementación de guías de trastornos comunes de salud mental en adultos, uno de los problemas más prevalentes a escala mundial. Método: Se realizó un estudio de revisión y compilación de recursos de implementación siguiendo el modelo PRISMA. Se localizaron y clasificaron herramientas y materiales con base en la taxonomía propuesta por el grupo EPOC de la Cochrane. Resultados: Se analizaron 212 elementos que se asocian a la implantación de guías de ansiedad generalizada y depresión (33,5 y 24,5%, respectivamente). Destaca la importante variedad de materiales disponibles, integrados en 3 estrategias fundamentales: intervenciones dirigidas a los profesionales (30,6%), estructurales (26,4%) y organizativas (24%). Las herramientas aplicadas son el tipo de recurso más frecuente, que permiten valorar la viabilidad de la puesta en marcha a nivel local. Conclusiones: La elaboración de guías no es suficiente para que se produzca su aplicación en la práctica. Es necesario que se lleven a cabo acciones que favorezcan su implementación. Los recursos y estrategias descritos podrían ser potencialmente aplicables a otros contextos y orientar a gestores y profesionales en el diseño de programas y en la toma de decisiones informadas, para mejorar el acceso a tratamientos eficaces en los sistemas públicos de salud (AU)

Introduction: There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide. Method: A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope. Results: A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%). Conclusions: Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments (AU)

Clinical guideline implementation strategies for common mental health disorders.

INTRODUCTION: There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide. METHOD: A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope. RESULTS: A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%). CONCLUSIONS: Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments.