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- W1990585446 abstract "Determinar el impacto de la implementación de una guía en la valoración del riesgo cardiovascular de pacientes en alto riesgo (diabéticos tipo 2), y en la adecuación del tratamiento antihipertensivo y antiagregante. Estudio semiexperimental, no aleatorizado, prospectivo, con grupo control concurrente. Dos centros de salud de Málaga. Médicos de familia. Implementación de la guía mediante intervenciones multicomponentes sobre los médicos de familia del centro experimental. Variable principal de resultado: grado de estimación del riesgo cardiovascular en población con elevado riesgo (diabéticos). Variables secundarias: adecuación del tratamiento antihipertensivo y antiagregante. Se detectaron importantes diferencias en la estimación del riesgo cardiovascular a favor del grupo experimental (el 74,36 frente al 7,63%; riesgo relativo [RR]=9,74; intervalo de confianza [IC] del 95%, 5,15–18,43; p=0,0001). Las pautas de antiagregación se ajustaron más a las recomendaciones de la evidencia en el grupo intervención (el 51,28 frente al 36,44%; RR=1,407; IC del 95%, 1,04–1,89; p=0,026), al igual que en antihipertensivos, aunque sin significación (el 80 frente al 66,27%; RR=1,207; IC del 95%, 0,99–1,46. Una estrategia de implementación multicomponente de una guía para el manejo de pacientes con elevado riesgo cardiovascular mejora la adherencia a intervenciones efectivas por parte de médicos de familia. 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. Quasi-experimental, non-randomised, prospective study with concurrent control group. Two health centres in Málaga. General practitioners of the two centres. The guideline was implemented through a multifaceted intervention in family physicians in the experimental centre. Rate of cardiovascular risk assessment in high risk population. Secondary: appropriateness of antihypertensive and antiplatelet treatment. 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). 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." @default.
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- W1990585446 date "2009-05-01" @default.
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- W1990585446 title "Mejora de la efectividad en el manejo del riesgo cardiovascular de pacientes diabéticos tipo 2 en atención primaria" @default.
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- W1990585446 doi "https://doi.org/10.1016/j.aprim.2008.09.006" @default.
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