title: [Implementation of a Clinical Practice Guidelines for the Management of Adults With Schizophrenia in Colombia].
abstract: OBJECTIVE
  To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations.
  
  
  METHODS
  The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process. During the GDG meetings implementation topics were identified and discussed, and later complemented by literature reviews concerning the experience of mental health guidelines implementation at national and international level. Additionally, feedback from the discussions raised during the socialization meetings, and joint meetings with the MSPS and the Institute of Technology Assessment in Health (IETS) were included. The prioritization of recommendations was made in conjunction with the GDG, following the proposed steps in the methodological guide for the development of Clinical Practice Guidelines with Economic Evaluation in the General System of Social Security in Colombian Health (GMEGPC) using the tools 13 and 14. the conclusions and final adjustments were discussed with the GPC_E leaders.
  
  
  RESULTS
  The implementation chapter includes a description of the potential barriers, solution strategies, facilitators and monitoring indicators. The identified barriers were categorized in the following 3 groups: Cultural context, health system and proposed interventions. The issues related to solving strategies and facilitating education programs include community mental health, mental health training for health workers in primary care, decentralization and integration of mental health services at the primary care level, use of technologies information and communication and telemedicine. To monitor and evaluate o the implementation process, five (5) indicators were designed one (1) structure, two (2) process and two (2)outcome indicators.
  
  
  CONCLUSIONS
  The GPC_E implementation within the Colombian General health System of Social Security (SGSSSC) poses multiple challenges. Potential barriers, enabling strategies and indicators for monitoring and evaluation described in this article, can provide efficient support to ensure the success of this process in the institutions that will adopt the guideline.
authors.affiliation: Médica psiquiatra, Pontificia Universidad Javeriana. Master en salud pública internacional, Bogotá, Colombia. Electronic address: nsanchezd@javeriana.edu.co.
authors.forename: Natalia
authors.initials: N
authors.lastname: Sánchez Díaz
authors.affiliation: Médico especialista en medicina familiar. Magíster en Epidemiología Clínica. Profesor asociado, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Andrés
authors.initials: A
authors.lastname: Duarte Osorio
authors.affiliation: Médico psiquiatra, psicoanalista, psiquiatra de enlace. Magíster en Epidemiología Clínica. Profesor titular, Director del Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Bogotá, Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gómez Restrepo
authors.affiliation: Médica psiquiatra. Magíster en Epidemiología Clínica. Profesora Asistente, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Adriana Patricia
authors.initials: AP
authors.lastname: Bohórquez Peñaranda
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003105:Colombia; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D009313:National Health Programs / Q000592:standards; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards; D012017:Referral and Consultation / Q000592:standards; D012559:Schizophrenia / Q000628:therapy*
keywords: Barreras y facilitadores; Barriers and facilitators; Clinical Practice Guidelines; Esquizofrenia; Guía de práctica clínica; Implementación; Implementation; Indicadores; Indicators; Schizophrenia