Guía de práctica clínica para el manejo de pacientes con fibrilación auricular en el Seguro Social del Perú (EsSalud)

espanolIntroduccion. El presente articulo resume la guia de practica clinica (GPC) para el manejo de pacientes con fibrilacion auricular (FA) en el Seguro Social del Peru (EsSalud). Objetivo. Proveer recomendaciones clinicas basadas en evidencia para el manejo de pacientes con FA en EsSalud. Metodos. Se conformo un grupo elaborador (GEG) que incluyo medicos especialistas y metodologos. El GEG formulo 9 preguntas clinicas a ser respondidas por la presente GPC. Se realizo busquedas sistematicas de revisiones sistematicas y ,cuando fue considerado pertinente, estudios primarios en Medline durante el 2017. Se selecciono la evidencia para responder cada una de las preguntas clinicas planteadas. La certeza de la evidencia fue evaluada usando la metodologia Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periodicas, el GEG uso la metodologia GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas practicas clinicas y los flujogramas de la GPC. Finalmente, la GPC fue aprobada con Resolucion N° 91 – IETSI – ESSALUD – 2018. Resultados. La presente GPC abordo 9 preguntas clinicas, divididas en tres temas: prevencion de eventos tromboembolicos, estrategias de control y manejo de FA en emergencias. En base a dichas preguntas se formularon 12 recomendaciones (6 recomendaciones fuertes y 6 recomendaciones condicionales), 29 puntos de buena practica clinica, y 2 algoritmos. Conclusion. El presente articulo resume la metodologia y las conclusiones basadas en evidencias de la GPC para manejo de pacientes con FA en EsSalud. EnglishAbstract. This article summarizes the clinical practice guide (CPG) for the management of patients with atrial fibrillation (AF) in the Social Security of Peru (EsSalud). Objective. To provide clinical recommendations based on evidence for the management of patients with AF in EsSalud. Methods. A CPG for the management of patients with AF in EsSalud was developed. To this end, a guideline development group (GDG) was established, including medical specialists and methodologists. The GDG formulated 9 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and ,when it was considered pertinent, primary studies were conducted in Medline during 2017. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of the CPG. Finally, the CPG was approved with Resolution No. 91 – IETSI – ESSALUD – 2018. Results. This CPG addressed 9 clinical questions, divided into three topics: prevention of thromboembolic events, maintenance therapy and management of AF. Based on these questions, 12 recommendations (6 strong recommendations and 6 weak recommendations), 29 points of good clinical practice, and 2 algorithms were formulated. Conclusion. This article summarizes the methodology and evidence-based conclusions from the CPG for the management of AF in EsSalud.