Síntese de recomendações de guias de prática clínica para farmacoterapia de osteoporose/
Data
2019-06-17
Autores
Martins, Tamiê de Camargo 
Orientadores
Melo, Daniela Oliveira de
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Há uma relação direta entre o envelhecimento e a incidência das doenças crônicas não transmissíveis (DCNT). Estas constituem um grande problema de saúde global, pela morbidade e mortalidade que causam. A osteoporose (OP) é uma DCNT multifatorial e os riscos que influenciam a sua manifestação podem ser individuais (fatores genéticos) ou ambientais. Para a padronização de condutas que auxiliam o raciocínio do profissional de saúde e a tomada de decisão terapêutica, tem-se o uso de Guias de Prática Clínica (GPC). A adaptação de recomendações de GPC de boa qualidade para a realidade local é uma boa opção para otimizar tempo e recursos. O objetivo deste trabalho foi sintetizar as recomendações sobre tratamento farmacológico extraídas de GPC de alta qualidade metodológica para o tratamento da OP. Os GPC para o tratamento de OP foram identificados pelo grupo de pesquisa CHRONIDE e avaliados por meio do instrumento AGREE II. As recomendações dos GPC de alta qualidade foram extraídas e posteriormente, sintetizadas e categorizadas de acordo com a população alvo de pacientes a que cada recomendação se referia, dando origem a quatro sínteses, sendo possível determinar quais os tópicos abordados de acordo com cada população alvo e comparar as recomendações, identificando aquelas que são consenso entre os GPC e as que diferem entre os documentos. Apesar da impossibilidade de se unificar as recomendações, devido a diferença entre as mesmas, elas se complementam. A maioria dos GPC recomenda o uso de bifosfonatos e outras opções terapêuticas para o tratamento de OP. Desta forma, a síntese de recomendações promove uma fonte de consulta fácil, confiável e atualizada para a tomada de decisão sobre o tratamento farmacológico e/ou processos de adaptações locais de GPC.
There is a direct relationship between population-ageing and the incidence of chronic noncommunicable diseases (NCDs). These diseases constitute a major global health problem because of the morbidity and mortality they cause. Osteoporosis (OP) is a multifactorial NCD, and the risks that influence its manifestation may be individual (genetic) or environmental. The Clinical Practice Guidelines (CPG) is used to standardize practices that support the health professional's reasoning and therapeutic decision-making. Adapting good quality CPG recommendations to the local reality is a good option for optimizing time and resources. The objective of this study is to compare the recommendations of pharmacological treatment extracted from CPG with high quality methodologic for the treatment of OP. The CPG for the treatment of OP were identified by the CHRONIDE research group and evaluated using the AGREE II instrument. The recommendations of the high-quality CPGs were extracted and subsequently synthesized and categorized according to the target population of patients to which each recommendation referred, giving rise to four syntheses, being possible to determine which topics were approached according to each target population and compare the recommendations, identifying those that are consensus between CPGs and those that differ between documents. Despite the impossibility of unifying the recommendations, due to the difference between them, they complement each other. Most CPGs recommend the use of bisphosphonates and other therapeutic options for the treatment of OP. Thus, the synthesis of recommendations promotes an easy, reliable and up-to-date source of consultation for pharmacological treatment decision-making and / or local CPGadaptation processes.
There is a direct relationship between population-ageing and the incidence of chronic noncommunicable diseases (NCDs). These diseases constitute a major global health problem because of the morbidity and mortality they cause. Osteoporosis (OP) is a multifactorial NCD, and the risks that influence its manifestation may be individual (genetic) or environmental. The Clinical Practice Guidelines (CPG) is used to standardize practices that support the health professional's reasoning and therapeutic decision-making. Adapting good quality CPG recommendations to the local reality is a good option for optimizing time and resources. The objective of this study is to compare the recommendations of pharmacological treatment extracted from CPG with high quality methodologic for the treatment of OP. The CPG for the treatment of OP were identified by the CHRONIDE research group and evaluated using the AGREE II instrument. The recommendations of the high-quality CPGs were extracted and subsequently synthesized and categorized according to the target population of patients to which each recommendation referred, giving rise to four syntheses, being possible to determine which topics were approached according to each target population and compare the recommendations, identifying those that are consensus between CPGs and those that differ between documents. Despite the impossibility of unifying the recommendations, due to the difference between them, they complement each other. Most CPGs recommend the use of bisphosphonates and other therapeutic options for the treatment of OP. Thus, the synthesis of recommendations promotes an easy, reliable and up-to-date source of consultation for pharmacological treatment decision-making and / or local CPGadaptation processes.