Healthcare practice is becoming more and more complex due to multiple factors, the most relevant being the exponential increase of scientific information.

To ensure that clinical decisions are appropriate, efficient and safe, healthcare professionals must constantly update their knowledge, an objective that entails great dedication and effort.

In the year 2003, the National Health System’s (NHS) Interterritorial Council created the HealthGuide project with the aim of improving evidence-based clinical decision-making by means of training activities and the configuration of a Clinical Practice Guidelines (CPG) register. Since then, the HealthGuide project has assessed dozens of CPGs in accordance with explicit criteria generated by its scientific committee, registered these CPGs and disseminated them throughout the Internet.

In early 2006, the Directorate General of the National Health System’s Quality Agency elaborated the Quality Plan for the NHS, a plan that encompasses twelve strategies. The objective of this Plan is to increase cohesion of the NHS and aid in guaranteeing maximum quality healthcare to all citizens, regardless of their place of residence. As part of the plan, the development of eight CPGs on prevalent pathologies related with health strategies was assigned to different agencies and experts groups. This guide on stroke prevention is part of this assignment.

Additionally, the establishment of a common CPG development methodology for the NHS was assigned to CPG experts groups in our country, resulting in a collective effort of consensus and coordination amongst them. In 2007, the HealthGuide project was renovated and the Clinical Practice Guideline Library was created. This project thoroughly covers the development of CPGs and includes other services and products of evidence-based medicine. It also aims to favour the implementation and assessment of the use of CPGs in the NHS.

Stroke represents a significant health problem due to its high prevalence, the disability it entails, the decreased quality of life it generates and its enormous economic impact. Despite current scientific evidence, great variability in primary and secondary prevention strategies is still being reported. This guideline is the result of the work of a group of professionals involved in different fields and settings. They have all dedicated a great effort to developing these recommendations, which will surely help improve health care delivered both in primary and specialised levels of care. Scientific societies and patient associations directly involved in this health problem have collaborated in the review process of this guideline.

This guideline provides answers to many of the questions posed by the preventive approach to stroke, which are presented in the form of systematically developed recommendations that are based on the best available evidence. We hope all this work translates into higher quality health care of these patients and their families, as well as into a greater homogeneity of health care, which is the objective that motivates us.

Dr. Alberto Infante Campos
General Director
Quality Agency of the National Health System