Hormigo Pozo A, Viciana López MA, Gómez Jiménez L, Gallego Parrilla MD, Orellana Lozano J, Morales Asencio JM. [Improved effectiveness in the management of cardiovascular risk among type 2 diabetic patients in primary health care].
Aten Primaria 2009;
41:240-5. [PMID:
19359066 DOI:
10.1016/j.aprim.2008.09.006]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Accepted: 09/08/2008] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES
To determine the impact of the implementation of a guidelines in the assessment of cardiovascular risk in high-risk patients (type 2 diabetes) in health centres, and to analyse the appropriateness of antihypertensive and antiplatelet treatment in diabetic patients.
DESIGN
Quasi-experimental, non-randomised, prospective study with concurrent control group. PLACEMENT: Two health centres in Málaga.
PARTICIPANTS
General practitioners of the two centres.
INTERVENTIONS
The guideline was implemented through a multifaceted intervention in family physicians in the experimental centre.
MAIN OUTCOMES
Rate of cardiovascular risk assessment in high risk population. Secondary: appropriateness of antihypertensive and antiplatelet treatment.
RESULTS
Large differences were detected in the cardiovascular risk assessment, improving in the experimental group (74.36% vs. 7.63%; RR = 9.74; 95% CI, 5.15-18.43; P = .0001). Similarly, the antiplatelet use was more in line with the guidelines recommendations in the intervention group (51.28% vs. 36.44%; RR = 1.407; 95% CI, 1.04-1.89; P = .026), and in antihypertensive drugs, although with no statistical significance (80% vs. 66.27%; RR = 1.207; 95% CI, 0.99-1.46).
CONCLUSIONS
A multifaceted intervention for the implementation of a guideline for the management of high risk cardiovascular patients, improves the adherence to effective interventions by family physicians.
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