Dissemination of HTA products. New lines of action

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

Casal Acción, Beatriz López García, MarisaVarela 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, 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.

“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.

National level

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)

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.

International level

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 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? 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 (II)

How?

Bibliographic review: updating search (Sobrido et al 2009).Medline (PubMed), HTA of CRD database,

ISI web of Science and Spanish Medical Index

Analysis of the organizations.-National: detailed specific questionnaire-International: agencies' websites & INAHTA’s

website

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

What aspects? Type of documents

HTA Reports (HTAr) Rapid Assessment (RA) Early Warning Brief Reports (EWBr) Clinical Practice Guidelines (CPG) Other types: Methodological documents, glossary…

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

Results: Target Audience

All agencies directed it’s documents to the decision makers, physicians and professional associations

Agencies produced citizen versions: 75%

Considered the Medical and Pharmaceutical Industry as a target audience: 25%

National

Results: Target Audience

All agencies directed it’s documents to the decision makers

Health Professionals: 93%

Agencies produced citizen versions: 14%

Medical and Pharmaceutical Industry: 8.7%

International

Type of documents

HTA reports: 100% Rapid Assessment: 100% 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

National

Type of documents

HTA reports: 100% Rapid Assessment: 45% Clinical Practice Guidelines: 24% Early Warning Brief Reports: 50 % Other types: 31.5%

• Methodological Documents• Versions for patients, carers & families• HTA Glossary

International

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) 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.

National & International

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: •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 the agencies and our final audience.

Thanks for your attention!

Contact person: Marisa Lópezavalia-t@sergas.es To Ceres