档次概念7:问题和见解,将指南建议与可靠的基本药物清单联系起来
Thomas Piggott1, Lorenzo Moja2, Kristina Jenei3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; Department of Family Medicine, Queens University, Kingston, Canada.
Journal of clinical epidemiology
|December 20, 2023
概括
将健康指南与必需药物清单 (EML) 保持一致,对于普及医疗覆盖至关重要. 这项研究提出了改善药物选择决策的解决方案,提高全球卫生公平性和获得基本药物的机会.
科学领域:
- 卫生政策 卫生政策
- 基于证据的医学基于证据的医学.
- 全球健康 全球健康
背景情况:
- 基本药物清单 (EML) 和临床指南对于医疗保健至关重要,但往往缺乏协调的决策过程.
- 世界卫生组织 (WHO) 的EML和国家EML (NEML) 引导全球医疗优先级,但对准挑战仍然存在.
- 确保获得必需药物是实现全民健康覆盖的基础.
研究的目的:
- 探索挑战,并提出解决方案,在指南制定和EML选择之间调整决策.
- 从推,评估,开发和评估 (GRADE) 工作组的角度来提高EML药物选择的可靠性.
- 提供适用于世卫组织EML和NEML过程的建议.
主要方法:
- 利益相关者参与和案例研究评估 (世卫组织EML,南非NEML,多发性硬化症指南) 用于确定挑战.
- 调查结果和利益相关者的反为制定概念框架提供了信息.
- 代项目组会议和GRADE工作组会议的反改进了框架.
主要成果:
- 关键的解决方案包括指导方针和EML组之间的早期调整,共享参与,以及更明确的价格/成本考虑.
- 建议制定明确的,共享的决策标准,以加强联系.
- 提供了改善世卫组织EML和NEML之间的联系的建议,包括上下文化.
结论:
- 结构化决策标准将指导方针建议与EML联系起来,可以改善健康公平.
- 解决EML和指导方针开发中的概念问题对于推动可靠的药物选择至关重要.
- 加强调整有潜力减少国家内部和国家之间的基本药物供应差距.
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