Evidence-based guidelines in a teaching primary care health service: The beginning of evidence-based medicine in the Amazonian region

Tags: Poster
Andriolo R1, Silva B2, Atallah N2
1Universidade do Estado do Paró - Brazil, 2Universidade Federal de São Paulo, Brazil

Background: Evidence-based guidelines (E-BGs) are an important tool to conduct translational research and for improving health servicesá quality and outcomes.

Objectives: To share information about the first implementation of E-BGs in one teaching primary care health service located in the Amazonian region.

Methods: The following actions were planned to achieve the

Objectives: i) mapping the health care and administrative teams; ii) evaluating the teamsá knowledge and perceptions of evidence-based medicine (EBM); iii) deliver an annual EBM course with topics on the Cochrane Collaboration; iv) mapping the diagnostic, preventive and therapeutic technologies most commonly used by each health specialty; v) hold consensus meetings involving internal and external health professionals, and the administrative body to prioritise themes, taking into account existing uncertainty, epidemiological relevance and costs; vi) preparing evidence-based medicine recommendations (EBMR); vii) holding a new consensus meeting to prepare E-BGs with multidisciplinary contributions to the EBMR documents, according to the local context; viii) comparing outcomes among patients when medical decisions were or were not based on the guidelines (Figure1).

Results: The first phase, already accomplished, shows that our health service is comprised of 50 administrative employees; 70 non-graduated health auxiliaries; and 112 graduate or post-graduate health professionals of different health areas and specialties including pharmacists, cardiologists, clinicians, otorhinolaryngologists, nurses, nutritionists, pediatricians and dentists and the service is responsible for more than 160,000 visits per year.

Conclusions: It is expected that successful implementation of the E-BGs will improve health outcomes and be more economical in this public health service. Moreover, this pilot experience with translational research is intended to be reproduced in the Health Department of Paró State, which is responsible for 143 cities located in a region with more than 7 million people characterized by an extreme paucity of human and economic resources for health care.