Conocimiento y aplicación de las guías de práctica clínica sobre riesgo cardiovascular en las consultas generales y especializadas

González-Juanatey, José Ramón; Alegría-Ezquerra, Eduardo; Aznar-Costa, Joaquín; Bertomeu‐Martínez, Vicente; Franch-Nadal, Josep; Palma-Gámiz, José L.

doi:10.1157/13091884

Cited by 43 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The explanation for such discouraging data can be due to many reasons such as poor experience in drugs management [2], low knowledge of guidelines recommendations [16,17], government health policies, or time limitations [3]. Our results show that cardiology patients received more frequently guidelinerecommended treatments, as ACEI or ARB in heart failure patients or oral anticoagulation in patient with AF.…”

Section: Discussionmentioning

confidence: 75%

“…The sample of patients recruited by the TRECE registry is very much alike to previous reports [2,3,8,16,17,24,25] and reflects mainly the daily practice of CHD: males over 65 years with various risk factors and the antecedent of myocardial infarction 5 years before. Regarding risk factors, the prevalence of obesity and smoking seems to be the most remarkable, in concordance to the results of the EUROASPIRE registry [25].…”

Section: Discussionmentioning

confidence: 99%

“…Relevant differences have also been described in chronic heart failure [13] although medical management of chronic CHD has not been largely studied. The low prescription of OMT in CHD patients can be explained by the presence of noncardiac diseases [14,15] but also by the differences in medical management according to different specialities [1,3,16,17]. The TRECE (Tratamiento de la Enfermedad Coronaria en España/treatment of coronary heart disease in Spain) registry was designed to describe risk factors control and medical treatment of CHD patients; the present analysis describes differences in clinical features and medical treatments of CHD patients according to medical speciality where they are attended.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Differences in Medical Treatment of Chronic Coronary Heart Disease Patients According to Medical Specialities

Cordero

Bertomeu‐Martínez

Mazón³

et al. 2009

Cardiovascular Therapeutics

Self Cite

View full text Add to dashboard Cite

Coronary heart disease (CHD) patients are currently attended by many different medical specialities. CHD patients must achieve the highest grade of treatment implementation and risk factors control. The aims were to describe differences in medical treatment of CHD according to the medical specialities. For this purpose we conducted an observational, cross-sectional, and multicenter study of CHD patients attended by internal medicine (IM), outpatient clinic cardiologist (OCC), hospital cardiologist (HC), and general practitioners (PC). Burden of noncardiac diseases was evaluated by the Charlson index. Joint prescription of antiplatelets, statins, beta-blockade agents and blockade of the renin-angiotensin system by angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptors blockers (ARB) was considered optimal medical treatment (OMT). A total of 2987 patients, mean age 67.4 (11.5) years and 71.5% males, were analyzed. Patients visited by IM physicians had slightly higher mean age and higher prevalence of hypertension, diabetes, and noncardiac diseases (median Charlson index 3.0, 1.0-5.0, vs. 2.0, 1.0-4.0, of total sample). OMT was prescribed in 25.9% (95% CI 25.6-26.2) of the patients and was statistically more frequently carried out by HC (32.1%) and OCC (29.0%) compared to IM (22.0%) and PC practitioners (21.5%). Multivariate analysis showed an independent association between OMT prescription and HC (OR 1.42; 95% CI 1.08-1.87) or OCC (OR 1.31; 95% CI 1.04-1.67); this association remained after including the Charlson index. Noncardiac diseases are the main clinical differences in CHD patients visited by different medical specialist although it does not explain the higher prescription of OMT by cardiologist.

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Differences in Medical Treatment of Chronic Coronary Heart Disease Patients According to Medical Specialities

Cordero

Bertomeu‐Martínez

Mazón³

et al. 2009

Cardiovascular Therapeutics

Self Cite

View full text Add to dashboard Cite

show abstract

“…Un registro llevado a cabo por la Sociedad Europea de Cardiología desveló que cerca de dos tercios de los cardiólogos y médicos de atención primaria estimaban el riesgo cardiovascular de forma subjetiva, y la mitad se quejaban de que las guías eran demasiado complejas de estudiar o consultar 40 . Igualmente, otro registro realizado en España mostró que el grado de conocimiento de las guías es más bajo en atención primaria que entre los especialistas, y que en general es mayor cuanto menor es el número de guías al respecto, salvo que existan documentos de aplicación nacional o regional 41 .…”

Section: Análisis De Las Causas Del Fracasounclassified

Control del colesterol LDL en pacientes de muy alto riesgo vascular. Algoritmo simplificado para alcanzar objetivos de colesterol LDL «en dos pasos»

Guijarro

Masana-Marin

Galve

et al. 2014

Clínica e Investigación en Arteriosclerosis

View full text Add to dashboard Cite

“…One of the great challenges that faces us at present is to ensure that all the professional involved adhere closely to the GPCs [7,17-20]. …”

Section: Introductionmentioning

confidence: 99%

Lipid-lowering drugs in ischaemic heart disease: A quasi-experimental uncontrolled before-and-after study of the effectiveness of clinical practice guidelines

Dalmau

Boira

Aguilar

et al. 2011

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundCardiovascular diseases(CVD), specifically ischaemic heart disease(IHD), are the main causes of death in industrialized countries. Statins are not usually prescribed in the most appropriate way. To ensure the correct prescription of these drugs, it is necessary to develop, disseminate and implement clinical practice guidelines(CPGs), and subsequently evaluate them.The main objective of this study is to evaluate the effectiveness of the implementation of consensual Lipid-lowering drugs (LLD) prescription guidelines in hospital and primary care settings, to improve the control of Low-Density Lipoprotein Cholesterol (LDL-C) levels in patients with IHD in the Terres de l'Ebre region covered by the Catalonian Health Institute. Secondary objectives are to assess the improvement of the prescription profile of these LLDs, to assess cardiovascular morbimortality and the professional profile and participant centre characteristics that govern the control of LDL-C.Methods/DesignDesign: Quasi-experimental uncontrolled before and after study. The intervention consists of the delivery of training strategies for guideline implementation (classroom clinical sessions and on-line courses) aimed at primary care and hospital physicians. The improvement in the control of LDL-C levels in the 3,402 patients with IHD in our territory is then assessed.Scope: Primary care physicians from 11 basic health areas(BHAs) and two hospital services (internal medicine and cardiology).Sample: 3,402 patients registered with IHD in the database of the Catalan Institute of Health(E-cap) before December 2008 and patients newly diagnosed during 2009-2010.Variables: Percentage of patients achieving good control of LDL-C, measured in milligrams per decilitre. The aim of the intervention is to achieve levels of LDL-C < 100 mg/dl in patients with IHD. Secondary variables measure type and time of diagnosis of IHD, type and dose of prescribed cholesterol-lowering drugs, level of physician participation in training activities and their professional profile.DiscussionThe development of prescription guidelines previously agreed by various medical specialists involved in treating IHD patients have usually improved drug prescription. The guideline presented in this study aims to improve the control of LDL-C by training physicians through presential and on-line courses on the dissemination of this guideline, and by providing feedback on their personal results a year after this training intervention.

show abstract

Conocimiento y aplicación de las guías de práctica clínica sobre riesgo cardiovascular en las consultas generales y especializadas

Cited by 43 publications

References 35 publications

Differences in Medical Treatment of Chronic Coronary Heart Disease Patients According to Medical Specialities

Differences in Medical Treatment of Chronic Coronary Heart Disease Patients According to Medical Specialities

Control del colesterol LDL en pacientes de muy alto riesgo vascular. Algoritmo simplificado para alcanzar objetivos de colesterol LDL «en dos pasos»

Lipid-lowering drugs in ischaemic heart disease: A quasi-experimental uncontrolled before-and-after study of the effectiveness of clinical practice guidelines

Contact Info

Product

Resources

About