Calidad y cumplimiento de guías de práctica clínica de enfermedades crónicas no transmisibles en el primer nivel

摘要

Objective. To assess the quality and compliance of clinical practice guidelines (CPG) applicable to chronic noncommunicable diseases (CNCD) in primary healthcare (CS),and views of staff on the barriers, facilitators and their use. Materials and methods . 18 valued CPG with AGREEII, 3 are selected to develop indicators and assess compliance using lot quality acceptance sample (LQAS, standard 75 / 95% threshold 40 / 75% respectively, α:0. 05, β:0. 10) on 5 CS. 70 professionals surveyed about knowledge and use of CPG. Results . Average quality of the CPG was 57.2%; low rating in domains: “Applicability” (25%), “Stakeholder involvement” (43.5%) and “Rigour of development” (55.0%). Compliance in CS ranges from 39 to 53.4%. Professionals show uneven knowledge of CPG; 44 to 45% (according to CPG), they declare that they are not used, they identify as main barriers the lack of training, and their difficult accessibility and management. Conclusions . The quality and implementation of evaluated CPG is deficient constituting an opportunity of improvement in health services.