National Health Guidelines in I.R of Iran, an Innovative Approach for Developing Countries

Mohammad Esmaeil Akbari--- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Gohar Mohammadi--- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Abbas Vosoogh-Moghaddam--- Health Sector Policy Coordination Group, in Charge of Minister for Policy Making Affairs Bureau, Ministry of Health and Medical Education, Tehran, Iran NCD Research Center, Endocrine and Metabolism Research Institute, Tehran University of Medical Sciences and Health Services, Tehran, Iran,
Fahimeh Rabanikhah--- Health service standardization and guidelines development, Ministry of Health and Medical Education, Tehran, Iran,
Hamideh Javadi--- Health Sector Policy Coordination Group, in Charge of Minister for Policy Making Affairs Bureau, Ministry of Health and Medical Education, Tehran, Iran,
Narges Rostami-Gooran--- Health Policy Secretariat, Ministry of Health and Medical Education, Tehran, Iran,
Asal Safaei--- Health service standardization and guidelines development, Ministry of Health and Medical Education, Tehran, Iran,
Atieh Akbari--- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract


1156

 

1. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2. Health Sector Policy Coordination Group, in Charge of Minister for Policy Making Affairs Bureau, Ministry of Health and Medical Education, Tehran, Iran

3. NCD Research Center, Endocrine and Metabolism Research Institute, Tehran University of Medical Sciences and Health Services, Tehran, Iran

4. Health service standardization and guidelines development, Ministry of Health and Medical Education, Tehran, Iran

5. Health Policy Secretariat, Ministry of Health and Medical Education, Tehran, Iran

 

 

 

 

 

Corresponding Author:

Gohar Mohammadi, MS.c

Ph.D Candidate in Cancer Research

Tel: (+98) 21 22748001

Email: g.mohammadi@sbmu.ac.ir

Received: 22 June 2014

Accepted: 03 Feb. 2015 

Iran J Cancer Prev. 2015; 2:77-83

 

 

Abstract

Background: Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose.

Methods: A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical  team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee.

Results: In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years.

Conclusion: National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care.

Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility.

 


Keywords


National Health; guideline; developing countries

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References


Neuhoff A and Searle R. More bang for the buck. Stanford Soc Innovation Rev. 2008;6:33-7.

Gagliardi AR, Brouwers MC and Bhattacharyya OK. The guideline implementability research and application network (GIRAnet): an international collaborative to support knowledge exchange: study protocol. Implement Sci. 2012;7:26.

Grimshaw J, Eccles M, Thomas R, et al. Toward Evidence‐Based Quality Improvement. J Gen Intern Med. 2006;21:514-20.

McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635-45.

FitzGerald JM, Boulet L-P, McIvor RA, Zimmerman S and Chapman KR. Asthma control in Canada remains suboptimal: the Reality of Asthma Control (TRAC) study. Canadian respiratory journal: journal of the Canadian Thoracic Society. 2006;13:253.

Latosinsky S, Fradette K, Lix L, Hildebrand K and Turner D. Canadian breast cancer guidelines: Have they made a difference? Can. Med. Assoc. J. 2007;176:771-6.

Francke AL, Smit MC, de Veer AJ and Mistiaen P. Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC medical informatics and decision making. 2008;8:38.

Ansari S and Rashidian A. Guidelines for guidelines: are they up to the task? A comparative assessment of clinical practice guideline development handbooks. PloS one. 2012;7:e49864.

Yang K, Chen Y, Li Y, et al. Editorial: can China master the guideline challenge? Health Research Policy and Systems. 2013; 11: 1.

Organization WH. Global programme on evidence for health policy. Guidelines for WHO guidelines. 2003.

Organization WH. WHO Handbook for guideline development. World Health Organization, 2012.

Woolf SH, Grol R, Hutchinson A, Eccles M and Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ: Br Med J. 1999; 318: 527.

Michie S and Lester K. Words matter: increasing the implementation of clinical guidelines. Quality and Safety in Health Care. 2005; 14: 367-70.

Oxman AD, Lavis JN and Fretheim A. Use of evidence in WHO recommendations. The Lancet. 2007;369:1883-9.

Grimshaw JM and Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. The Lancet. 1993; 342: 1317-22.

Worrall G, Chaulk P and Freake D. The effects of clinical practice guidelines on patient outcomes in primary care: a systematic review. Can. Med. Assoc. J. 1997; 156: 1705-12.

Fervers B, Burgers J, Voellinger R, et al. Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation. BMJ quality & safety. 2011;20:228-36.

Graham ID, Beardall S, Carter AO, et al. What is the quality of drug therapy clinical practice guidelines in Canada? Can. Med. Assoc. J. 2001;165:157-63.

Oxman AD, Schünemann HJ and Fretheim A. Improving the use of research evidence in guideline development: 2. Priority setting. Health Res Policy Syst. 2006;4:14.

Network SIG. SIGN 50: A guideline developers' handbook. Scottish Intercollegiate Guidelines Network, 2001.

Collaboration A. The ADAPTE Process: Resource Toolkit for Guideline Adaptation. Version 2.0. 2009.

Ministers abtCo, Europe otCo, 2001 oO and memorandum ae. Developing a Methodology for Drawing up Guidelines on Best Medical Practices. 2001 ed.: Council of Europe Publishing, (2001)13.

Bosch-Capblanch X, Lavis JN, Lewin S, et al. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development. PLoS Medicine. 2012;9:1001185.

Hibble A, Kanka D, Pencheon D and Pooles F. Guidelines in general practice: the new Tower of Babel? Bmj. 1998;317:862-3.

Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T and Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. Journal of Continuing Education in the Health Professions. 2007;27:94-102.

Dobbins M, Hanna SE, Ciliska D, et al. A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implementation Science. 2009; 4: 61.

Michie S and Johnston M. Changing clinical behaviour by making guidelines specific. BMJ: British Medical Journal. 2004;328:343.

Baradaran-Seyed Z, Nedjat S, Yazdizadeh B, Nedjat S and Majdzadeh R. Barriers of Clinical Practice Guidelines Development and Implementation in Developing Countries: A Case Study in Iran. Int. J. Prev. Med. 2013;4:340.

Bikdeli B, Kermani S, Beyhaghi H, et al. The appropriate approach for adoption of clinical practice guidelines in the national health system, according to the experienced project in Iran national health system. Hakim Research Journal. 2010;13:49-57.

Akbari.MS. Nation Health guidelines. 2013, p.591.