Subsídios para uma estratégia de produção, seleção e disseminação de evidências em saúde

Abstract

This study proposes potential input and guidelines for the design of public policies for the selection and dissemination of evidence in health aimed at the informational needs of health professionals (doctors and nurses). The research was divided into three stages. In the first stage, the National Policy on Health Information and Informatics was analyzed in its preliminary (2004) and definitive (2016) versions, alongside a technical note from 2013; the State Health Plan of the State of São Paulo for the years 2012 to 2015 and 2016 to 2019; the National Policy on Science, Technology and Innovation in Health (2008); the Information for Health (National Health Service); Health Online: the Health Information Action Plan for Australia and the Canada Health Infoway. In the second stage, the qualitative data from the Evid@SP research (Impact of the information made available on the Evidence Based Health portal on clinical practice of health professionals in the state of São Paulo) was analyzed, in which 342 health professionals working in the state of São Paulo participated, resulting in about 451 comments. From this data, the comments of medical doctors and nurses were selected for analysis in the present research in order to identify the main informational needs of these predominant health professionals in the health system in Brazil. In the third stage, a synthesis of the data collected in the first two stages plus the literature review was carried out in order to obtain potential input for the elaboration of a public policy of the selection and dissemination of evidence in health. In the results, we identified which of the analyzed policies do or do not mention evidence in health. Also, the informational needs identified in the physicians’ and nurses' comments were separated in four thematic categories, which are: application of the evidence in practice; barriers to the use of evidence; awareness of the need for updating their current state of knowledge; format, reliability and mode of evidence. After comparing the first two phases with the literature review, it was possible to identify issues that contemplate the agenda of a policy of selection and dissemination of evidence in health. The points presented as inputs to future strategies were related to the terminology of the policies and plans; incentive for the production of evidence, clinical protocols and national therapeutic guidelines and of the culture of practice based on evidence; dissemination of the Evidence-based Health Portal; training of human resources; guarantee of electronic resources for access to evidence. The conclusion reached is that the current policies and plans do not attend to the process of the production and dissemination of evidence in the national health system.