Dissemination of HTA products. New lines of action

“This document was elaborated within the collaborat ion framework established by Quality Plan for the N ational Health System of the Ministry of Health, Social Services and Equality, under the collaborati on agreement signed between the Institute of Health Carlos III, an autonomous organism part of the Spanish Ministry of Economy and Competitiveness, an d the A Coruña University Complex Foundation”

López García, MarisaCasal Acción, BeatrizVarela Lema, LeonorAlcázar Alcázar, Raimundo

Scope

� HTA consolidated its role of providing

the policy-makers and health-

managers with the best available

evidence.

� New audiences: health professionals, � New audiences: health professionals,

academics, certain industries,

patients and the general public.

� Difficulties to bridge the gap between

agencies and our target audience.

Background

� The dissemination of HTA products has been a

strategic area of interest for avalia-t & Aunet’s

agencies.

� Avalia-t has led Aunet’s Working Group of

experts in the Area of Dissemination, 2006.

National level

experts in the Area of Dissemination, 2006.

“Strategies for the diffusion and dissemination of

health technology assessment products”

(Sobrido, et al 2009) Avaliat&Aunets.

� It sets a continuous line of collaboration in

Aunets.

Background

� International level

� The International Network of Agencies for HTA (INAHTA):

� WG2 Communication (2002)

� The European Network for Health Technology Assessment (EUnetHTA):

� WP2 Communications (2006-2008)

� WP2 Dissemination (2010-2012)

International level

� WP2 Dissemination (2010-2012)

� Institute of Health Economics (IHE) “Effective Dissemination of Findings from

Research” (2008).

Some studies show that certain reports do not impact as intended in the target audience:

� [Demands and expectations for health technology assessment: qualitative analysis from the

perspective of decision makers and clinicians] Varela-Lema L et al.2011.

� Maximizing the impact of systematic reviews in health care decision making: a systematic

scoping review of knowledge-translation resources. Chambers D. 2011.

Objectives

� Evaluate policies and initiatives for the

dissemination of HTA products (National &

International ).

� Assess to what degree the recommendations

made by the Diffusion Responsible Working 1

made by the Diffusion Responsible Working

Group (Sobrido et al1, 2009) have been

implemented within the Spanish Network HTA

Agencies diffusion policies.

� Identify improvement areas and propose new

strategies and lines of action.

1-Sobrido Prieto M, González Guitián C, Cerdá Mota T, Group of technicians and experts in documentation and diffusion/dissemination belonging to the

Spanish Health Technology Assessment Agencies & Units. Strategies for the diffusion and dissemination of health technology assessment (HTA) products.

Madrid: Ministry of Science & Innovation; 2009. Report No.: avalia-t Núm. 2007 / 07.

Evaluate policies and initiatives for the dissemination of HTA products (I)

Which organizations?

� Spanish Network of HTA Agencies & Units (AUnETS).

� International Network of Agencies for Health Technology Assessment (INAHTA).

Who?Who?

� Technical group:

� Unit of Documentation of avalia-t: bibliographic review and detailed analysis.

� Working group:

� Documentalist and diffusion responsibles of Spanish Network of HTA Agencies

(Aunet’s Working Group): reviewed de draft and agreed upon the recommendations.

Evaluate policies and initiatives for the dissemination of HTA products (I)

How?

� Bibliographic review: updating search

(Sobrido et al 2009)(Sobrido et al 2009)

Medline (PubMed), HTA of CRD database,

ISI web of Science and Spanish Medical Index

� Analysis of the organization

-National: detailed specific questionnaire

-International: agencies' websites & INAHTA’s

website

Evaluate policies and initiatives for the dissemination of HTA products (II)

What aspects?

� Type of documents

� HTA Reports (HTAr)

� Rapid Assessment (RA)

� Early Warning Brief Reports (EWBr)

� Clinical Practice Guidelines (CPG)

� Other types: Methodological documents, evaluative research...

� Targeted audience

� Decision Makers: Policy Makers & Health Managers (PM)

� Health Professionals (HP)

� Patients and General Public (Cz)

� Medical & Pharmaceutical Industry (MI)

� Strategies

� Documental Support

� Identification of techniques and processes of diffusion and dissemination

80%

100%100%

100%

Target audience. Spain 2011

Results: Target Audience

� All agencies directed it’s documents to

the decision makers, physicians and

professional associations

National

0%

20%

40%

60%

80%

DMHP

CzMI

100%

75%

25%

Type of audienceDecision Makers

Health Professionals

Citizens

Medical Industry

� Agencies produced citizen versions: 75%

� Considered the Medical and

Pharmaceutical Industry as a target

audience: 25%

Results: Target Audience

� All agencies directed it’s documents

to the decision makers

� Health Professionals: 93%

International

80%

100%100%

93,47%

Target audience.

International situation 2011

� Health Professionals: 93%

� Agencies produced citizen versions:

14%

� Medical and Pharmaceutical

Industry: 8.7%

0%

20%

40%

60%

80%

DMHP

CzMI

93,47%

14%8,69%

Type of AudienceDecision Makers

Health Professionals

Citizens

Medical Industry

Type of documents

� HTA reports: 100%

� Rapid Assessment: 100%

� Clinical Practice Guidelines: 87.5%

National

80%

100%100% 100%

87,5%

Type of documents.

Spanish situation 2011

� Clinical Practice Guidelines: 87.5%

� Early Warning Brief Reports: 50%

� Other types: 37.5%

• Methodological Documents

• Versions for patients, carers & families

• HTA Glossary

• Evaluative Research reports

0%

20%

40%

60%

HTAr RACPG

EWBrOther

87,5%

50%

37,5%

Type of DocumentsHTA reports

Rapid Assessments

Clinical Practice Guidelines

Early Warning Brief Reports

Others

Type of documents

� HTA reports: 100%

� Rapid Assessment: 45%

� Clinical Practice Guidelines: 24%

International

100%100%

Type of documents.

International situation 2011

� Clinical Practice Guidelines: 24%

� Early Warning Brief Reports: 50 %

� Other types: 31.5%

• Methodological Documents

• Versions for patients, carers & families

• HTA Glossary

• Evaluative Research Reports

0%

20%

40%

60%

80%

HTAr RACPG

EWBrOther

100%

47%

24,4%33,3%

31,1%

Type of documentsHTA reports

Rapid Assessments

Clinical Practice Guidelines

Early Warning Brief Reports

Others

Dissemination Policies

Channels

� 100% / 100% agencies maintained and updated their website.

� 50% / 65% agencies published News Bulletins.

� 35% / 26% Web 2.0, Twitter being the most used.

� 50% / 45% used alert systems or RSS systematically.

Formats (national)

National & International

Formats (national)

� 100% undertook technical sessions

(Hospitals, Primary Care, Healthcare Administration…).

� 100% Published medical articles in specialized journals and reported in

congresses.

� All published HTA reports are collected in main International databases

(CRD, Cochrane & Cochrane Library Plus…).

Dissemination (national)

� 75%: Agencies have a person responsible for the dissemination area.

Implementation of recommendations about policies and strategies

of dissemination 2011

Versions and channels

• A short version for Policy Makers and Health Managers has been developed by avalia-t

and proposed as reference for AUnETS’ working group.

• Currently 75% of AUnETS Agencies have elaborated patient and family versions (0% in

2009)

• Health professionals: indexed articles in Medline (AUnETS’s agencies) has not varied in

relevant number of data references between 2009 and 2011.

• 50 % Agencies edit an e-mail newsletter (which has been maintained between 2009

and the present day).

Impact measure

• According to the results of an external analysis1, the perceived impact of HTA reports,

in Spain, is low (scarcely cited in investigation papers).

1Parada-Martinez A, Gutierrez-Ibarluzea I. Evaluación del impacto bibliográfico de las agencias y unidades españolas de evaluación de tecnologías sanitarias.

Barcelona: Agència d`Informació, Avaluació i Qualitat en Salut de Cataluña; 2011

Recommendations

VISIBILITY:

• Creating and maintaining a common database of ongoing projects to

facilitate inter-agency coordination and the creation of synergies.

• A scientific repository operated and maintained jointly by the AUnETS

network should be implemented.

VERSIONS: VERSIONS:

• A short version for HTA products, should be systematically created.

• A scientific paper targeted at the research audience.

DOCUMENTAL SUPPORTS:

• Use of electronic support whenever possible: browseble PDF format

• New supports: e-books, format for mobile devices…

Recommendations

CHANNELS

• Use of web 2.0 and social networking sites should multiply the point

access to the reports.

• The request of a space for HTA products within the national journals

specialized in the field of health-care administration and management.

• Issuing a common electronic bulletin for HTA agencies or a blog.

• Boost AuNets website in order to give it more functionalities and make it

more friendly for internal users and citizens.

GLOSSARY

• Normalize the denomination of documents by a common glossary.

� We expect that all these

recommendations will be

useful and help us to bridge

the gap between thethe gap between the

agencies and our final

audience.

Thanks for your attention!

Marisa López García

avalia-t@sergas.esTo Ceres