FIGO good practice recommendations on the importance of registry data for monitoring rates and health systems performance in prevention and management of preterm birth

ObjectivesDevelopment of evidence-based good practice recommendations for clinicians considering the use of antibiotics in patients towards the end of life.DesignA multiprofessional group of experts in end-of-life care and antimicrobial stewardship was convened. Findings from a scoping review of the literature and a consultation of clinicians were triangulated. Expert discussion was used to generate consensus on how to approach decision-making.SettingRepresentatives from hospital and a range of community health and care settings.ParticipantsMedical, pharmacy and nursing professionals.Main outcome measuresGood practice recommendations based on published evidence and the experience of prescribers in Scotland.ResultsThe findings of 88 uncontrolled, observational studies of variable quality were considered alongside a survey of over 200 prescribers. No national or international guidelines were identified. Antibiotic use towards the end of life was common but practice was highly variable. The potential harms associated with giving antibiotics tended to be less well considered than the potential benefits. Antibiotics often extended the length of time to death but this was sometimes at the cost of higher symptom burden. There was strong consensus around the importance of effective communication with patients and their families and making treatment decisions aligned to a patient’s goals and priorities.ConclusionsGood practice recommendations were agreed with focus on three areas: making shared decisions about future care; agreeing clear goals and limits of therapy; reviewing all antibiotic prescribing decisions regularly. These will be disseminated widely to support optimal care for patients towards the end of life. A patient version of the recommendations has also been produced to support implementation.

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Decentralisation and Health Systems Performance in Developing Countries

Health Information Systems ◽

10.4018/978-1-60566-988-5.ch070 ◽

2011 ◽

pp. 1115-1139

Author(s):

Adebusoye A. Anifalaje

Keyword(s):

Developing Countries ◽

Health Systems ◽

Care Delivery ◽

Healthcare Delivery ◽

Analytical Models ◽

Top Down ◽

Decision Space ◽

Primary Health ◽

Health Systems Performance ◽

Administrative Structures

This article attempts to elucidate the intricacies of primary health care delivery in Nigeria. Among myriad complexities, the central proposition made herein is that the absence of an effective regulatory and enforcement framework in developing countries results in a prominent informal decision space. The findings show that the prominence of an informal decision space compromises the objectives of an information-based public health system. The article concludes that decentralisation in developing countries must have a coordinated top-down and bottom-up development component for it to be effective in improving the performance of primary health systems. One of the implications of the study is that researching decentralised healthcare delivery requires analytical models which are able to illuminate the complexities of local accountability in developing countries. The study also reveals the need to further research the dynamics of democratic decentralisation in developing countries as this goes beyond administrative structures but involve socio-cultural institutions.

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PP14 Development Of The European Network For Health Technology Assessment Standards Tool For Registries In Health Technology Assessment

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318001861 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 70-70

Author(s):

Emmanuel Gimenez Garcia ◽

Mireia Espallargues ◽

Jae Long ◽

Maja Valentic ◽

Irena Guzina ◽

...

Keyword(s):

Health Technology Assessment ◽

Technology Assessment ◽

Good Practice ◽

Health Technology ◽

Registry Data ◽

European Network ◽

Real World Data ◽

The Third ◽

Evidence Quality ◽

Evidence Generation

Introduction:Bridging gaps between registry-holders, Health Technology Assessment (HTA) producers and users is one of the aims of the European Network for HTA (EUnetHTA) Joint Action 3. In this context, a post-launch evidence generation tool is being developed, including a quality standards tool for registries in HTA. The standards tool for registries in HTA will enable, among others, registry owners to consistently collect high quality registry data, and HTA agencies to use proper registry data collected by others as evidence for their assessments. The objective is to present the first draft version of the tool structure, which is going to be piloted during the forthcoming months.Methods:A review and description of the currently available first version (November 2017) sections, items and criteria for HTA studies.Results:The tool is divided in three sections; “Methodological Information”, “Essential Standards” and “Additional Requirements”. The first section enables users to analyze not only the ability of the registry to answer to research questions but also to check the registry transparency. The second section encloses the essential elements of good practice and evidence quality (therefore all of them must be met before an HTA report can use the registry data). Finally, the third section includes elements of good practice and evidence quality useful to consider in planning and evaluating registries for specific purposes. Although suggestions are defined, the third section item requirements could depend on the individual HTA agency perspectives and needs.Conclusions:There is a clear growing availability and requirement for real world data for health technology assessment. A piloted and robust registry standards tool for HTA can provide a relevant basis to improve both the evidence generation but also to make more trustful and excellent evaluations.

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Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK

JAC-Antimicrobial Resistance ◽

10.1093/jacamr/dlz026 ◽

2019 ◽

Vol 1 (2) ◽

Cited By ~ 7

Author(s):

Ann L N Chapman ◽

Sanjay Patel ◽

Carolyne Horner ◽

Helen Green ◽

Achyut Guleri ◽

...

Keyword(s):

Quality Improvement ◽

Antimicrobial Therapy ◽

Good Practice ◽

Service Evaluation ◽

Consultation Process ◽

Outpatient Parenteral Antimicrobial Therapy ◽

Practice Recommendations ◽

Extensive Consultation ◽

Adults And Children ◽

The Uk

AbstractUK good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) were published in 2012 and 2015 for adult and paediatric patients, respectively. Here we update the initial good practice recommendations in a combined document based on a further review of the OPAT literature and an extensive consultation process. As with the previous good practice recommendations, these updated recommendations are intended to provide pragmatic guidance for new and established OPAT services across a range of settings and to act as a set of quality indicators for service evaluation and quality improvement.

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