dc.contributor.author | Rodríguez-Salvanés, Francisco J. | |
dc.contributor.author | Novella, Blanca | |
dc.contributor.author | Fernández Luque, María Jesús | |
dc.contributor.author | Sanchez-Gámez, L. M. | |
dc.contributor.author | Ruiz Díaz, Lourdes | |
dc.contributor.author | Sánchez-Alcalde, Rosa | |
dc.contributor.author | Sierra-García, Belén | |
dc.contributor.author | Mayayo-Vicente, Soledad | |
dc.contributor.author | Ruiz-Lápez, Marta | |
dc.contributor.author | Loeches, Pilar | |
dc.contributor.author | López-Gánzalez, Javier | |
dc.contributor.author | Gonzalez-Gamarra, Amelia | |
dc.date.accessioned | 2015-01-09T13:19:34Z | |
dc.date.available | 2015-01-09T13:19:34Z | |
dc.date.issued | 2011-06-22 | |
dc.identifier.citation | BMC Family Practice 12 (2011): 21 | en_US |
dc.identifier.issn | 1471-2296 | es_ES |
dc.identifier.uri | http://hdl.handle.net/10486/663031 | |
dc.description.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 | en_US |
dc.description.sponsorship | 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° 031216 | en_US |
dc.format.extent | 6 pag. | es_ES |
dc.format.mimetype | application/pdf | en |
dc.language.iso | eng | es_ES |
dc.publisher | BioMed Central | en_US |
dc.relation.ispartof | BMC Family Practice | en_US |
dc.rights | © 2011 Rodríguez-Salvanés et al. | es_ES |
dc.subject.other | Cardiovascular disease | en_US |
dc.subject.other | Clinical practice guidelines | en_US |
dc.subject.other | Cluster analysis | en_US |
dc.subject.other | Primary healthcare | en_US |
dc.subject.other | Randomised clinical trial | en_US |
dc.title | 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 | en_US |
dc.type | article | en |
dc.subject.eciencia | Medicina | es_ES |
dc.relation.publisherversion | http://dx.doi.org/10.1186/1471-2296-12-21 | es_ES |
dc.identifier.doi | 10.1186/1471-2296-12-21 | es_ES |
dc.identifier.publicationfirstpage | 21 | es_ES |
dc.identifier.publicationlastpage | 21 | es_ES |
dc.identifier.publicationvolume | 12 | es_ES |
dc.type.version | info:eu-repo/semantics/publishedVersion | en |
dc.rights.cc | Reconocimiento | es_ES |
dc.rights.accessRights | openAccess | en |
dc.institutoUAM | Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-Princesa) | |