Efficacy of a strategy for implementing a guideline for the control of cardiovascular risk in a primary healthcare setting: The SIRVA2 study a controlled, blinded community intervention trial randomised by clusters
Publisher
BioMed CentralDate
2011-06-22Citation
10.1186/1471-2296-12-21
BMC Family Practice 12 (2011): 21
ISSN
1471-2296DOI
10.1186/1471-2296-12-21Funded by
Funding for the trial was provided by the Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+I). Instituto de Salud Carlos III - Fondo de Investigación Sanitaria. Expediente N° 031216Editor's Version
http://dx.doi.org/10.1186/1471-2296-12-21Subjects
Cardiovascular disease; Clinical practice guidelines; Cluster analysis; Primary healthcare; Randomised clinical trial; MedicinaRights
© 2011 Rodríguez-Salvanés et al.Abstract
This work describes the methodology used to assess a strategy for implementing clinical practice guidelines (CPG)
for cardiovascular risk control in a health area of Madrid.
Background: The results on clinical practice of introducing CPGs have been little studied in Spain. The strategy
used to implement a CPG is known to influence its final use. Strategies based on the involvement of opinion
leaders and that are easily executed appear to be among the most successful.
Aim: The main aim of the present work was to compare the effectiveness of two strategies for implementing a
CPG designed to reduce cardiovascular risk in the primary healthcare setting, measured in terms of improvements
in the recording of calculated cardiovascular risk or specific risk factors in patients’ medical records, the control of
cardiovascular risk factors, and the incidence of cardiovascular events.
Methods: This study involved a controlled, blinded community intervention in which the 21 health centres of the
Number 2 Health Area of Madrid were randomly assigned by clusters to be involved in either a proposed CPG
implementation strategy to reduce cardiovascular risk, or the normal dissemination strategy. The study subjects
were patients ≥ 45 years of age whose health cards showed them to belong to the studied health area. The main
variable examined was the proportion of patients whose medical histories included the calculation of their
cardiovascular risk or that explicitly mentioned the presence of variables necessary for its calculation. The sample
size was calculated for a comparison of proportions with alpha = 0.05 and beta = 0.20, and assuming that the
intervention would lead to a 15% increase in the measured variables. Corrections were made for the design effect,
assigning a sample size to each cluster proportional to the size of the population served by the corresponding
health centre, and assuming losses of 20%. This demanded a final sample size of 620 patients. Data were analysed
using summary measures for each cluster, both in making estimates and for hypothesis testing. Analysis of the
variables was made on an intention-to-treat basis
Files in this item
Google Scholar:Rodríguez-Salvanés, Francisco J.
-
Novella, Blanca
-
Fernández Luque, María Jesús
-
Sanchez-Gámez, L. M.
-
Ruiz Díaz, Lourdes
-
Sánchez-Alcalde, Rosa
-
Sierra-García, Belén
-
Mayayo-Vicente, Soledad
-
Ruiz-Lápez, Marta
-
Loeches, Pilar
-
López-Gánzalez, Javier
-
Gonzalez-Gamarra, Amelia
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.
-
A cluster-randomised clinical trial comparing two cardiovascular health education strategies in a child population: The Savinghearts project
Sánchez-Gómez, Luis María; Fernández Luque, María Jesús; Ruiz Díaz, Lourdes; Sánchez-Alcalde, Rosa; Sierra-García, Belén; Mayayo-Vicente, Soledad; Ruiz-López, Marta; Loeches-Belinchón, Pilar; López-Gónzález, Javier; González-Gamarra, Amelia; Gallego Arenas, Angela; Cubillo-Serna, Ana; Gil-Juberias, Gema; Pérez-Cayuela, Pilar; Arana Cañedo-Arguelles, Celina; García Pascual, Julia Natividad; Ruiz-Chércoles, Esther; Suárez Fernández, M. Carmen; García-Polo, Iluminada; Abad Pérez, Daniel; Ballesteros-Arribas, Juan Manuel; Izquierdo Martínez, Maravillas; Salvador-Alcaide, Elena; Arribas-Vela, Ana B.; Alonso-Pérez, Juan M.; Veja-Piris, Lorena; Rodríguez-Salvanés, Francisco J.; Novella Arribas, Blanca
2012-11-27 -
Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled trial
Mediavilla Torres, Roberto; McGreevy, Kerry R.; Felez-Nobrega, Mireia; Monistrol-Mula, Anna; Bravo Ortiz, María Fe
; Bayón Pérez, Carmen
; Rodríguez Vega, Beatriz
; Nicaise, Pablo; Delaire, Audrey; Sijbrandij, Marit; Witteveen, Anke B.; Purgato, Marianna; Barbui, Corrado; Tedeschi, Federico; Melchior, Maria; van der Waerden, Judith; McDaid, David; Park, A. La; Kalisch, Raffael; Petri-Romão, Papoula; Underhill, James; Bryant, Richard A.; Haro, Josep Maria; Ayuso Mateos, José Luis
; RESPOND Consortium
2022-10-05 -
A randomized multicenter clinical trial to evaluate the efficacy of melatonin in the prophylaxis of SARS-CoV-2 infection in high-risk contacts (MeCOVID Trial): A structured summary of a study protocol for a randomised controlled trial
García García, Irene; Rodríguez-Rubio, Miguel; Rodríguez Mariblanca, Amelia; Martínez de Soto, Lucía; Díaz García, Lucía; Monserrat Villatoro, Jaime; Queiruga Parada, Javier; Seco Meseguer, Enrique; Rosales, María J.; González, Juan; Arribas, José R.; Carcas Sansuán, Antonio Javier; Oliva Senovilla, Pedro de la
; Borobia Pérez, Alberto M.
2020-06-03