Competency profiles for evidence-informed policy-making (EIPM): a rapid review.

BACKGROUND: Evidence-informed policy-making (EIPM) requires a set of individual and organizational capacities, linked with background factors and needs. The identification of essential knowledge, skills and attitudes for EIPM can support the development of competency profiles and their application in different contexts. PURPOSE: To identify elements of competency (knowledge, skills and attitudes) for EIPM, according to different professional profiles (researcher, health professional, decision-maker and citizen). METHODS: Rapid umbrella review. A structured search was conducted and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with distinctive designs were included, published from 2010 onwards, without language restrictions. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis was used to report the findings. RESULTS: Ten reviews were included. A total of 37 elements of competency were identified, eight were categorized as knowledge, 19 as skills and 10 as attitudes. These elements were aggregated into four competency profiles: researcher, health professional, decision-maker and citizen. The competency profiles included different sets of EIPM-related knowledge, skills and attitudes. STRENGTHS AND LIMITATIONS: This study is innovative because it aggregates different profiles of competency from a practical perspective, favouring the application of its results in different contexts to support EIPM. Methodological limitations are related to the shortcuts adopted in this review: complementary searches of the grey literature were not performed, and the study selection and data extraction were not conducted in duplicate. FINAL CONSIDERATIONS: CONCLUSIONS AND IMPLICATIONS OF THE FINDINGS: EIPM requires the development of individual and organizational capacities. This rapid review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability of capacity and the need for its development in different contexts.

Assessing the impact of knowledge communication and dissemination strategies targeted at health policy-makers and managers: an overview of systematic reviews.

BACKGROUND: The use of research evidence as an input for health decision-making is a need for most health systems. There are a number of approaches for promoting evidence use at different levels of the health system, but knowledge of their effectiveness is still scarce. The objective of this overview was to evaluate the effectiveness of knowledge communication and dissemination interventions, strategies or approaches targeting policy-makers and health managers. METHODS: This overview of systematic reviews used systematic review methods and was conducted according to a predefined and published protocol. A comprehensive electronic search of 13 databases and a manual search in four websites were conducted. Both published and unpublished reviews in English, Spanish or Portuguese were included. A narrative synthesis was undertaken, and effectiveness statements were developed, informed by the evidence identified. RESULTS: We included 27 systematic reviews. Three studies included only a communication strategy, while eight only included dissemination strategies, and the remaining 16 included both. None of the selected reviews provided "sufficient evidence" for any of the strategies, while four provided some evidence for three communication and four dissemination strategies. Regarding communication strategies, the use of tailored and targeted messages seemed to successfully lead to changes in the decision-making practices of the target audience. Regarding dissemination strategies, interventions that aimed at improving only the reach of evidence did not have an impact on its use in decisions, while interventions aimed at enhancing users' ability to use and apply evidence had a positive effect on decision-making processes. Multifaceted dissemination strategies also demonstrated the potential for changing knowledge about evidence but not its implementation in decision-making. CONCLUSIONS: There is limited evidence regarding the effectiveness of interventions targeting health managers and policy-makers, as well as the mechanisms required for achieving impact. More studies are needed that are informed by theoretical frameworks or specific tools and using robust methods, standardized outcome measures and clear descriptions of the interventions. We found that passive communication increased access to evidence but had no effect on uptake. Some evidence indicated that the use of targeted messages, knowledge-brokering and user training was effective in promoting evidence use by managers and policy-makers.

¿Es una alternativa terapéutica la pancrelipasa (Zenpep®) para pacientes con fibrosis quística?: síntesis rápida de evidencia / Is pancrelipase (Zenpep®) a therapeutic alternative for patients with cystic fibrosis?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO La fibrosis quística es una enfermedad multisistémica asociada a un componente genético, que se caracteriza por la presencia constante de secreciones en múltiples órganos, siendo las exacerbaciones pulmonares las que conllevan la mayor morbilidad y mortalidad. El Ministerio de Salud, a través del plan de Garantías Explícitas en Salud (GES), comprende dentro de su cobertura para esta condición de salud, las terapias de reemplazo enzimático para insuficiencia pancreática. Sin embargo, existe un único laboratorio que cuenta con registro sanitario en Chile (pancreatina). De esta forma, se le ha solicitado al Ministerio la inclusión de otras alternativas terapéuticas disponibles y, en particular de pancrelipasa (Zenpep®). En este contexto la Secretaría Técnica GES solicita una síntesis de evidencia con el objetivo de informar la toma de decisiones respecto de si es posible contar con una alternativa terapéutica a la pancreatina (Creon®) para pacientes con fibrosis quística. METODOLOGÍA Se formula una estrategia de búsqueda para ser utilizada en las bases de datos Epistemonikos, la Biblioteca Cochrane, y PubMed con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Al no encontrarse revisiones que abordaran las comparaciones deseadas, se realizó una búsqueda de estudios primarios en PubMed. Los resultados de la búsqueda se presentan en los hallazgos del presente documento. Se utiliza la metodología de certeza de la evidencia GRADE. Se incluyeron todas las preparaciones de pancrelipasa con cualquier nombre comercial. Se utilizó como comparador único placebo, priorizando éste por sobre la pancreatina. RESULTADOS Se utilizan 8 estudios primarios, de los cuales se obtienen los siguientes resultados: -En comparación a placebo, el uso de pancrelipasa en niños con fibrosis quística, podría au mentar la absorción de grasa y nitrógeno en un 34,5% y 34.6%, respectivamente. -La utilización de pancrelipasa en población adulta con fibrosis quística, podría aumentar la absorción de grasa y nitrógeno en un 38.5% y 34.5%, respectivamente. -La pancrelipasa no cuenta con registro sanitario vigente en Chile por lo que, de momento, habría que esperar la solicitud de registro, para incorporarla como alternativa terapéutica en pa cientes tratados en nuestro país.

Estratégias para estimular o uso de evidências científicas na tomada de decisão / Encouraging the use of scientific evidence in decision making

Um importante desafio para os sistemas de saúde é promover o uso sistemático do conhecimento em políticas públicas que busquem, ao mesmo tempo, melhorar a eficiência e as condições de saúde da população. O objetivo deste artigo foi identificar e discutir estratégias para estimular o uso de evidências científicas no processo de tomada de decisão em políticas de saúde. A busca de evidências científicas foi realizada nos repositórios da Biblioteca Virtual em Saúde, Health Systems Evidence e PubMed. A ferramenta SUPPORT (Supporting Policy Relevant Reviews and Trials) foi usada na construção desse panorama. Sete revisões sistemáticas apontaram quatro principais estratégias para estimular o uso de evidências na tomada de decisão: 1) produzir e disseminar sínteses de evidência com linguagem adaptada a diferentes públicos; 2) estimular o uso do jornalismo e de outras formas de comunicação para ampliar a disseminação do conhecimento científico; 3) utilizar plataforma virtual on-line para disseminação do conhecimento científico; 4) promover a interação entre pesquisadores e tomadores de decisão. Estratégias para estimular o uso de evidências científicas na tomada de decisão em saúde podem ser desenvolvidas de maneira sinérgica, mas é necessário considerar o contexto local e as implicações das estratégias para o sistema de saúde como um todo.

A major challenge for health systems is to promote the use of scientific evidence supporting public policies that seek to improve efficiency and the health of the population. The objective of this study was to identify and discuss strategies to encourage the use of scientific evidence in the process of health decision making. The search was performed in the repositories of the Virtual Health Library, Health Systems Evidence and PubMed. SUPPORT (Supporting Policy Relevant Reviews and Trials) Tools were used for the preparation of this overview. Seven systematic reviews were used to identify options to stimulate the use of evidence for decision making: 1) Produce policy briefings with adapted language for different audiences; 2) Stimulate the use of journalism and other forms of mass communication for dissemination of scientific knowledge; 3) Implement online platforms for dissemination of scientific knowledge, and; 4) Promote the dialogue between researchers and policy makers. Strategies to encourage the use of scientific evidence in health decision making can be implemented in a synergistic way; however, it is important to assess the local context and the implications of each strategy for the health system as a whole.