gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Portuguese Guidelines born out of US independent academic materials: A cross-Atlantic collaboration to improve rational prescribing in Portugal during an economic crisis context

Meeting Abstract

  • D. Silverio Rodrigues - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal
  • P. Caetano - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal
  • B. Heleno - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal
  • D. Pinto - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal
  • E. Monteiro - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal
  • I. Santos - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisbon, Portugal

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP118

DOI: 10.3205/12gin230, URN: urn:nbn:de:0183-12gin2305

Published: July 10, 2012

© 2012 Silverio Rodrigues et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: The May 2011 memorandum of understanding concerning a 78 Billion € loan to Portugal, led by the International Monetary Fund, demanded the 'Establishment of clear rules for prescription of drugs on the basis of international prescription guidelines'. Producing guidelines from scratch is time and resource intensive. Adapting existing materials from a strong US academic group (iDiS) was a solution.

Objectives: To outline the adaption of rational prescribing materials from one country to another, economically and rapidly.

Methods: Translation and adaptation made by an academic Portuguese team in two stages: cultural adaptation using focus groups with 13 family physicians; Public and National Association of Physicians´ specialists consultation.

Results: Focus groups led to inclusion of local terminology, changes in format. Consultation uncovered some frailties in evidence appraisal. These originated changes negotiated with original authors. In 10 months and spending 12,000 € to pay the rights for original materials, three family physicians and two pharmacologists spent an estimated total of 250 hours per guideline pro bono and published 3 guidelines.

Discussion: Cultural and local translation increased acceptability. Adaptation was thorough and extensively peer-reviewed yet faster and less expensive than if original materials had been created. The outside origin made it easier to shield the guidelines from unduly local commercial influences. One guideline alone can improve patient safety and save 12 million € per year.

Implications for guideline developers/users: faced with scarce time and budget, adapting academic materials from recognized international groups may be a good alternative to new guideline creation.