Comparação entre tratamento farmacológico de diretrizes clínicas internacionais e Protocolos Clínicos e Diretrizes Terapêuticas
Data
2025-01-21
Autores
Martino, Clara Regina Paschoali 
Orientadores
Melo, Daniela Oliveira de
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As diretrizes clínicas são documentos essenciais para otimizar a qualidade dos cuidados em saúde, enquanto os Protocolos Clínicos e Diretrizes Terapêuticas (PCDTs), elaborados pela Comissão Nacional de Incorporação de Tecnologias (Conitec), têm caráter normativo e são de observância obrigatória para os profissionais do Sistema Único de Saúde (SUS). Este estudo tem como objetivo comparar o tratamento farmacológico preconizado nos PCDTs com as recomendações presentes em diretrizes clínicas internacionais. Para isso, foram utilizados PCDTs extraídos pelo uso da plataforma Research Eletronic Data Capture (RedCap®) e diretrizes clínicas de quatro repositórios internacionais: National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Veterans Affairs and the Department of Defense (Va/DoD) e Ministerio de Salud del Chile (MINSAL). A análise foi feita em Excel® para identificar semelhanças e discrepâncias entre as recomendações dos dois documentos. Foram identificados 101 PCDTs vigentes entre 2002 e 2022, com diretrizes clínicas disponíveis para 35,64% dos temas. Em 30,55% dos casos, todos os medicamentos recomendados nos PCDTs estavam também nas diretrizes clínicas internacionais, enquanto para 3 condições, mais de 75% dos medicamentos estavam presentes apenas nos PCDTs. A comparação mostrou ao avaliar se as recomendações de diretrizes clínicas também estavam previstas em PCDTS que, em 19,44% das condições clínicas, houve 100% de compatibilidade entre as recomendações, enquanto 25% apresentaram maior discrepância. Conclui-se que, para a maioria dos temas abordados, não foi identificada diretriz clínica equivalente e que, em relação às recomendações encontradas em PCDTs, a compatibilidade foi superior a 70% nas comparações com diretrizes clínicas internacionais.
Clinical guidelines are essential documentation for optimizing healthcare quality, while Clinical Protocols and Therapeutic Guidelines (PCDTs), that are envisaged by the National Comission for Technology Integration / Comissão Nacional de Incorporação de Tecnologias (Conitec) have normative characteristics and are obligatory for Sistema Único de Saúde (SUS) professionals. This study has as an objective the comparison between pharmacological treatment conceived by PCTDs with international clinical guidelines. To that effect the used PCDTs were extracted with the Research Electronic Data Capture (RedCap®) platform using four major clinical directive repositories: National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Veterans Affairs and the Department of Defense (Va/DoD) e Ministerio de Salud del Chile (MINSAL). Analysis was performed using Excel® software in order to identify similarities and discrepancies between the documentations. We have identified 101 PCTDs effective between 2002 and 2022 with clinical directives available for 35,64% of the themes. In 30,55% of the cases, all recommended medication by the PCDTs were also present in international clinical guidelines, for 3 conditions over 75% of the medication were present for the PCDTs only. The comparison showed when evaluating whether clinical guidelines recommendations were also provided for in PCDTS that 19,44% of the clinical conditions 100% of compatibility was found between recommendations, while 25% presented themselves with higher discrepancy. We conclude that for most of the broached subjects we did not identify a compatible or equivalent clinical guideline, in relation to PCDTs, however the compatibility was superior to 70% when comparing them to international clinical guidelines.
Clinical guidelines are essential documentation for optimizing healthcare quality, while Clinical Protocols and Therapeutic Guidelines (PCDTs), that are envisaged by the National Comission for Technology Integration / Comissão Nacional de Incorporação de Tecnologias (Conitec) have normative characteristics and are obligatory for Sistema Único de Saúde (SUS) professionals. This study has as an objective the comparison between pharmacological treatment conceived by PCTDs with international clinical guidelines. To that effect the used PCDTs were extracted with the Research Electronic Data Capture (RedCap®) platform using four major clinical directive repositories: National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Veterans Affairs and the Department of Defense (Va/DoD) e Ministerio de Salud del Chile (MINSAL). Analysis was performed using Excel® software in order to identify similarities and discrepancies between the documentations. We have identified 101 PCTDs effective between 2002 and 2022 with clinical directives available for 35,64% of the themes. In 30,55% of the cases, all recommended medication by the PCDTs were also present in international clinical guidelines, for 3 conditions over 75% of the medication were present for the PCDTs only. The comparison showed when evaluating whether clinical guidelines recommendations were also provided for in PCDTS that 19,44% of the clinical conditions 100% of compatibility was found between recommendations, while 25% presented themselves with higher discrepancy. We conclude that for most of the broached subjects we did not identify a compatible or equivalent clinical guideline, in relation to PCDTs, however the compatibility was superior to 70% when comparing them to international clinical guidelines.
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