Atributos de las guías clínicas del régimen de garantías en salud relacionados con su adopción en la atención primaria: una evaluación en 3 centros de salud familiar / Attributes of recommendations included in clinical guidelines that influence their implementation in clinical practice
Rev. méd. Chile
; 145(11): 1429-1436, nov. 2017. tab
Artigo
em Espanhol
| LILACS
| ID: biblio-902463
Biblioteca responsável:
CL1.1
RESUMEN
Background A number of attributes of recommendations included in clinical guidelines influence their implementation in clinical practice. Aim To assess the association between those attributes and the uptake of recommendations included in four Clinical Guidelines of the Chilean Ministry of Health. Material and Methods The compliance with recommendations was assessed auditing a random sample of 1,547 electronic medical records of patients with four selected clinical conditions (hypertension, diabetes, depression and asthma) in three primary care centers. Nine evaluators judged the presence or absence of six attributes in each recommendation (restrictive/prescriptive, complexity, trialability, actionability, observability, flexibility). We compared the degree of uptake of recommendations with the presence of these attributes. Results The compliance with recommendations was highly variable, with a median of 51% and ranging from 0 to 98%. There was an association between the uptake of recommendations and the presence of three of the above mentioned attributes. There was a higher implementation of restrictive rather than prescriptive recommendations, of rigid rather than flexible recommendations and those recommendations susceptible to be experimented first. Conclusions We have identified three attributes associated with the implementation of recommendations included in four primary care clinical guidelines. These findings could be useful for the guidelines development process in the Chilean national guidelines program.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.8 Atingir a cobertura universal de saúde
/
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Arranjos de Entrega
/
Objetivo 6: Sistemas de informação em saúde
Base de dados:
LILACS
Assunto principal:
Atenção Primária à Saúde
/
Asma
/
Padrões de Prática Médica
/
Fidelidade a Diretrizes
/
Depressão
/
Diabetes Mellitus
/
Hipertensão
Tipo de estudo:
Estudo de avaliação
/
Guia de prática clínica
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Criança
/
Feminino
/
Humanos
País/Região como assunto:
América do Sul
/
Chile
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Pontificia Universidad Católica de Chile/CL