Background In 2012 the Swedish National Board of Health and Welfare introduced National Guidelines for Musculoskeletal Diseases. The National guidelines are evidence based and directed at politicians and decision makers. A major objective of the guidelines is to increase the degree of scientific consideration of the decisions concerning health care. The guidelines include the diagnosis; rheumatoid arthritis, osteoporosis, osteoarthritis in the knee and hip, inflammatory spinal disease, axial spondyloarthritis, ankylosing spondylitis and psoriatic arthritis. In 2014 the first evaluation of the National Guidelines were presented and the work with establishing target levels has commenced.
The Swedish Rheumatism association has used a series of different strategies in order to affect both the content of the guidelines but also their implementation and evaluation.
Objectives The aim of the guidelines is contribute to the development of a high standard of medical care and social services. Moreover, the aim of the guidelines is to stimulate the use of evidence based and effective measures and to serve in support of transparent and systemic priorities in health care.
As the guidelines ultimately affects the members of the Swedish Rheumatism Association, the Swedish Rheumatism Association has actively sought to impact and participate in their development and implementation.
Methods When the guidelines were first developed the Swedish Rheumatism association was not included as a partner in expert groups nor as a consultation body. The Swedish Rheumatism actively sought to influence the National Board of Health and Welfare to invite them as members of the different expert groups and when this proved unproductive they instead turned directly to the involved experts.
Moreover, representatives from the Swedish Rheumatism association frequently participated in panel debates on the topic. The association actively sought to be invited to forums where the guidelines were discussed. Furthermore, several articles were written on the topic.
When the guidelines were published the Swedish Rheumatism Association began to work with the guidelines within the organisation. The material has been used at networking courses but also introduced at a regional level of the organisation to ensure that the regional elected representatives are able to use them in their advocacy.
Results The effect of the implementation of the guidelines were evaluated by the National Board of Health and Welfare in 2013. As part of the implementation of the guidelines the Board has developed about 40 indicators for monitoring the healthcare of individuals with musculoskeletal conditions. In time for the evaluation of the implementation of the guidelines the Swedish Rheumatism association has been included by the National Board of Health and Welfare in the consensus group and as a consultation body.
Conclusions There are weaknesses in the guidelines and in particular there are questions regarding their effect but the implementation of the guidelines have opened up for a systemic review and evaluation of the health care for people with musculoskeletal disease. The implementation has also provided a framework for an ongoing dialog between patients, health care professionals, scientists and authorities.
To conclude, the Swedish Rheumatism association have gained a position where they are a consultation body to the National Board of Health and Welfare on the National Guidelines for Musculoskeletal Diseases.
Disclosure of Interest None declared
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