Article type
Abstract
Background :
The INEAS has established a clinical care pathway for the management of Acute Coronary Syndrome (ACS) in Tunisia, addressing the unique challenges faced by the healthcare system. This project aims to promote safe and efficient management of ACS patients, ensuring appropriate care based on their health conditions
Objectives :
Standardize ACS pathway in Tunisian different centers adapted to their local conditions and levels of care, by optimising the coordination between all healthcare professionnals.
Method :
A comprehensive review of literature across various international databases was conducted to delineate the clinical care pathway for ACS and to formulate a tailored local pathway.
The evidence from different clinical practice guidelines and references were analyzed with specific tools. The ACS recommendations from European Society of Cardiology 2023, Australia pathway, and Malaysia ACS guideline 2019 were utilized and customized to suit our local context. When there is no evidence, Tunisian expert opinions are considered by using Delphi method to contextualize the evidence-based and align them with our local values, preferences and contexts.
The ministry of health and health insurance were involved to ensure better implementation and enhance health care access, equity and quality.
Results:
While global evidence is standardizing the management of ACS worldwide, some barriers are encountered in their daily application. This can be explained by:
- The financial implications in terms of resources;
- The organizational challenges: the rapid transfert of patients presenting an ACS to available centers 24/24 H and capable of performing percutaneous angioplasty using well-equipped ambulances accompanied by trained paramedical and medical staff;
- The availability of fibrinolytics;
- Public-private partnership to guarantee equitable access to healthcare services.
Conclusion:
The match between evidence about ACS and the local context impact significantly the quality and the outcomes of the intervention. It involves allocating resources, obtaining administrative support, and considering the values of stakeholders to enhance the effectiveness of interventions.
The implementation of coordinated efforts and a dedicated digital application for ACS management in Tunisia will be developed and evaluated later.
The INEAS has established a clinical care pathway for the management of Acute Coronary Syndrome (ACS) in Tunisia, addressing the unique challenges faced by the healthcare system. This project aims to promote safe and efficient management of ACS patients, ensuring appropriate care based on their health conditions
Objectives :
Standardize ACS pathway in Tunisian different centers adapted to their local conditions and levels of care, by optimising the coordination between all healthcare professionnals.
Method :
A comprehensive review of literature across various international databases was conducted to delineate the clinical care pathway for ACS and to formulate a tailored local pathway.
The evidence from different clinical practice guidelines and references were analyzed with specific tools. The ACS recommendations from European Society of Cardiology 2023, Australia pathway, and Malaysia ACS guideline 2019 were utilized and customized to suit our local context. When there is no evidence, Tunisian expert opinions are considered by using Delphi method to contextualize the evidence-based and align them with our local values, preferences and contexts.
The ministry of health and health insurance were involved to ensure better implementation and enhance health care access, equity and quality.
Results:
While global evidence is standardizing the management of ACS worldwide, some barriers are encountered in their daily application. This can be explained by:
- The financial implications in terms of resources;
- The organizational challenges: the rapid transfert of patients presenting an ACS to available centers 24/24 H and capable of performing percutaneous angioplasty using well-equipped ambulances accompanied by trained paramedical and medical staff;
- The availability of fibrinolytics;
- Public-private partnership to guarantee equitable access to healthcare services.
Conclusion:
The match between evidence about ACS and the local context impact significantly the quality and the outcomes of the intervention. It involves allocating resources, obtaining administrative support, and considering the values of stakeholders to enhance the effectiveness of interventions.
The implementation of coordinated efforts and a dedicated digital application for ACS management in Tunisia will be developed and evaluated later.