Spain

GuíaSalud

GuíaSalud is a national project in which all Spanish regions participate and it is managed by the Aragon Health Sciences Institute (I+CS). The mission of GuíaSalud is to develop and make available to the Spanish National Health Service (NHS) an information and recording system, and the implementation and updating of clinical guidelines.

Since 2006, a national programme for the development of clinical guidelines based on scientific evidence has been developed, promoted by the Quality Plan for the NHS and coordinated by the I+CS, as unit of GuíaSalud. In this programme participate The Agencies and Health Technology Assessment Units from Catalonia (CAHTA), Galicia (AVALIA-T), Madrid (AGENCIA LAIN ENTRALGO), Basque Country (OSTEBA) and the Iberoamerican Cochrane Centre.

As a part of this programme, the methodological handbook for the development of clinical guidelines has been developed, available on the website of GuíaSalud (www.guiasalud.es). The development of eight clinical guidelines has been launched. These are about Eating Disorder, Attention to patients with schizophrenia (updating), Management of Depression in adult people, Management of patients with anxiety disorders in Primary Care, Primary and secondary prevention of Ictus, Type 2 Diabetes, Palliative care, and Treatment of prostate cancer.

The new goals of this programme are to develop two methodological handbooks for update and implementation of clinical guidelines and the elaboration of thirteen guidelines which already started in 2007. The topics of these clinical guidelines are Attention to patients with Osteoporosis – Risk of fractures, Preventive, diagnostic and therapeutic management of bronchiolitis in breast feeding infants, Attention Deficit Hyperactivity Disorder, Depression in adolescents, Patient security in surgical procedures, Tuberculosis, Obesity in infant and young people, Sleep disorders in Primary Care, Immunodeficiency management in Primary Care, Autism, Type 1 Diabetes, Normal birth and Serious mental illness.

GuíaSalud is also developing other areas of work addressed to health professionals, patients and other agents interested in Evidence-Based Medicine so that they can find a space addressing to all their needs in terms of consultation, formation, elaboration, diffusion and implementation of all products of EBM.

The Catalan Agency for Health Technology Assessment of Catalonia

The Catalan Agency for Health Technology Assessment of Catalonia (CAHTA) is a non-profit public company attached to the CatSalut-Catalan Health Service. The CAHTA was created in 1994. Since 2006 it has been a member of the G-I-N and the GuíaSalud Scientific Committee.

The CAHTA’s missions include supporting decision-making at different levels of the health system and promoting suitable and precise information to facilitate this process. This context explains why CAHTA has been linked to Clinical Practice Guidelines (CPG) since 1994, as a channel for the transfer of know-how. The CAHTA has outstanding experience in the development of scientific evidence-based CPG through: preparation, assessment and/or review of CPG, teaching activity and publications.

The CAHTA has participated since 2006 in the programme for the preparation of CPG sponsored by the Quality Plan of the Ministry of Health and Consumer Affairs. Within this plan, it has also participated in the writing of the guide on the Major Ambulatory Surgery Unit. Currently, in the framework of the collaboration agreements between the Catalan Department of Health and the CAHTA, the following CPG are being developed: Borderline personality disorders, pathological gambling and other behavioural addictions, dementias and the update of the Oncoguias [cancer guidelines].

The CAHTA provides training related to the writing of CPG, featuring the participation of members of the groups that draw up the guidelines or those promoted by other institutions. The CAHTA is a partner in the international project Coordination of Cancer Clinical Practice Guidelines Research in Europe (CoCanCPG) (www.cocancpg.eu).

For further information please check out the CAHTA website: www.aatrm.net

Osteba

Osteba is the Office for Health Technology Assessment belonging to the Health Department of the Basque Government. It was created in 1992. It was member of the AGREE Collaboration and a founder of G-I-N. Last year Osteba promoted, through commissioned research projects, the development of clinical guidelines at a regional level, and since 2006 it also works in the framework of the national programme for development of clinical guidelines promoted by the Spanish National Health Service Quality Plan.

Thanks to the multidisciplinary effort of a wide group of professionals from the Basque Health Service – Osakidetza – seven clinical guidelines based on evidence have been developed: Arterial Hypertension, Asthma, Low Back pain, Head Injuries, Dislipemia, Type 2 Diabetes and Palliative care. At  present, clinical guidelines about Type 1 Diabetes and Normal birth are being developed. The development of clinical guidelines has by four formative modules: Formulation of questions, Literature search, Critical appraisal of evidence and Formulation of recommendations. In the same way, a report Description of methodology for development, adaptation and updating of clinical   guidelines, has been developed: available in the methodological section of www.osanet.euskadi.net/osteba/es. At the moment, another project about implementation of clinical guidelines is being developed in the context of the Basque Country.

Osteba is organising a series of formative activities about the GRADE system with the participation of clinical guidelines development groups from several agencies and organizations in Spain. Next May 12th, 13th and 14th there will be a workshop “How to teach GRADE” in Donostia-San Sebastián, with Andy Oxman, Holger Schuneman and Victor Montori as teachers.

Redeguías

Redeguías is a group of researchers, without a defined structure, that connects two more stable teams, one in Galicia, organised round FISTERRA and another one in Seville, organised round the Internal Medicine Service of the University Hospital Valme and the Enebro Foundation. In addition, there are some people and teams collaborate on specific projects.

Last year, it worked on the development of clinical guidelines and it collaborates in the framework of the national programme for development of clinical guidelines based on scientific evidence promoted by the Quality Plan for the NHS. Redeguías participates in research projects about evaluation, use and implementation of clinical guidelines and also on formation courses for Scientific Societies and Assistance Units. The FISTERRA group coordinates a knowledge management web for primary care, with special attention to clinical guidelines. The Enebro Foundation in Seville coordinates the Iberoamerican Clinical Guidelines Network with 56 members from 18 Spanish and Portuguese-speaking countries, dedicated to the promotion of clinical guidelines in this idiomatic context.

For further information:

CAHTA Maria-Dolors Estrada (destrada@aatrm.catsalut.net)

Osteba Rosa Rico (rosarico-osteba@ej-gv.es) • Marta López de Argumedo (osteba5-san@ej-gv.es)

Redeguías Fisterra: Arturo Louro (alourog@gmail.com) • Enebro: Ignacio Marín (ignacio.marin.sspa@juntadeandalucia.es)

GuíaSalud (Aragon Health Sciences Institute) Flavia Salcedo (fsalcedo.iacs@aragon.es) • María Bono (mbono.iacs@aragon.es)