Author(s)

Maria Jesús Fernández-Luque^1,2, Luis María Sánchez-Gómez^2.3.4, Vicente Pastor y Aldeguer⁵, Carmen Suárez-Fernández^2,5,6, Belén Sierra-García^2,7, Soledad Mayayo-Vicente^2,7, Marta Ruiz-López^2,7, Ángela Gallego-Arenas^2,7, Rosa Sánchez Alcalde^2,7, Pilar Loeches-Belinchón^2,7, Javier López-González², Francisco Rodríguez-Salvanés^2,6,8, Blanca Novella-Arribas^2,7,8*

¹Dirección General de Investigación, Docencia y Documentación, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain.
²Instituto de Investigación Sanitaria del Hospital, Universitario de La Princesa (IP), Madrid, Spain.
³Agencia de Evaluación de Tecnologías Sanitarias (AETS), ISCIII, Madrid, Spain.
⁴Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
⁵Universidad Autónoma de Madrid, Facultad de Medicina, Madrid, Spain.
⁶Hospital Universitario de la Princesa, SERMAS, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain.
⁷Gerencia Asistencial de Atención Primaria, D.G. de Coordinación de Asistencia Sanitaria, SERMAS, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain.
⁸Unidad de Evaluación de Tecnologías Sanitarias de Madrid, Procesos Integrados de Salud, Consejería de Sanidad, Madrid, Spain.

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

Randomized Controlled Trial, Cluster Analysis, Clinical Practice Guidelines, Primary Healthcare, Risk Factors, Cardiovascular Diseases

Fernández-Luque, M. , Sánchez-Gómez, L. , y Aldeguer, V. , Suárez-Fernández, C. , Sierra-García, B. , Mayayo-Vicente, S. , Ruiz-López, M. , Gallego-Arenas, Á. , Sánchez Alcalde, R. , Loeches-Belinchón, P. , López-González, J. , Rodríguez-Salvanés, F. and Novella-Arribas, B. (2020) Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare. World Journal of Cardiovascular Diseases, 10, 117-130. doi: 10.4236/wjcd.2020.103013.