Ensayo clínico aleatorizado para evaluar la eficacia de un programa integral de prevención secundaria de las enfermedades cardiovasculares en atención primaria: estudio PREseAP

Brotons, Carlos; Soriano, Núria; Moral, Irene; Rodrigo, María Pilar; Kloppe, Pilar; Rodríguez, Ana Iglesias; González, María Luisa Soriano; Ariño, Dolores; Orozco, D.; Buitrago, Francisco; Pepió, J.M.; Borrás, Isabel

doi:10.1016/j.recesp.2010.07.005

Cited by 28 publications

(9 citation statements)

References 17 publications

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“…We conducted an ambispective observational cohort study in the primary care setting, with the participation of 21 healthcare centres in eight Spanish regions (Catalonia, Castilla y León, Madrid, the Basque Country, Aragon, the Balearic Islands, Extremadura and the Valencian Community). Participants were selected from the control group of the PREseAP study [ 11 , 12 ]. We included all CVD patients who attended primary care consultations between January 2004 and May 2005 and who met the inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

“…With the aim of improving patient care in secondary prevention, in 2011 our research team assessed the efficacy of a comprehensive programme for secondary cardiovascular prevention in primary care (PREseAP study [ 11 , 12 ]). The programme did not effectively reduce cardiovascular morbidity and mortality, but it did improve some aspects related to healthy habits.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study

Vilaubí

Orozco‐Beltrán

Gonçalves

et al. 2018

IJERPH

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To provide a better understanding of the actions taken within health systems and their results, this study aims to assess clinicians’ adherence to clinical practice guidelines (CPGs) regarding recommended treatments in patients with cardiovascular disease in primary care settings, and to determine the associated factors. We conducted an ambispective cohort study in 21 primary care centres in 8 Spanish regions. Patients diagnosed with coronary heart disease, stroke and/or peripheral arterial disease were included. Patients who received the treatment recommended in the European guidelines on cardiovascular disease prevention (CPG’s adherent group) were compared with patients who did not (CPG’s non-adherent group). The outcome variables were cardiovascular hospital admissions, all-cause and cardiovascular mortality during follow-up. Of the 438 participants, 38.6% (n = 169) received the drug therapies recommended in the guidelines. The factors that increased the likelihood of good adherence to CPG’s were being diagnosed with hypertension (p = 0.001), dyslipidaemia (p < 0.001) or diabetes (p = 0.001), and not having a psychiatric disorder (p = 0.005). We found no statistically significant association between good adherence to CPG’s and lower incidence of events (p = 0.853). Clinician adherence to guidelines for secondary prevention of cardiovascular disease was low in the primary care setting.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study

Vilaubí

Orozco‐Beltrán

Gonçalves

et al. 2018

IJERPH

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“…In three articles, 18–20 we calculated the OR by using the mean anxiety score in survivors vs. non-survivors, and in another four 15,19,21,22 we used the mortality rates in anxious vs. non-anxious individuals.…”

Section: Methodsmentioning

confidence: 99%

Association between anxiety and mortality in patients with coronary artery disease: A meta-analysis

Celano

Millstein

Bedoya

et al. 2015

American Heart Journal

247

126

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Background Depression and anxiety are common in patients with coronary artery disease (CAD). While depression clearly has been associated with mortality in this population, the relationship between anxiety and mortality is less clear. Accordingly, we performed a series of meta-analyses to (1) examine the relationship between anxiety and mortality in patients with established CAD and (2) determine if this relationship differs in patients with stable CAD compared to those who have just suffered an acute coronary syndrome (ACS). Methods and Results Systematic literature searches identified 44 articles (total N=30,527) evaluating the prospective relationship between anxiety and mortality in individuals with established CAD. A series of eight adjusted and unadjusted meta-analyses were performed to examine this relationship across all patients, with sensitivity analyses completed in post-ACS and stable CAD cohorts. In unadjusted analyses, anxiety was associated with a moderate increase in mortality risk (odds ratio=1.21 per standard deviation increase in anxiety). However, when adjusting for covariates, nearly all associations became non-significant. In sensitivity analyses, anxiety was associated with an increased risk of poor outcomes in the stable CAD—but not post-ACS—cohort. Conclusions These analyses confirm that anxiety is associated with increased risk of mortality in patients with CAD; however, this relationship is not as strong as that of depression and may be explained partly by other clinical factors. If anxiety screening is performed, it should be performed during a period of clinical stability and should target anxiety disorders rather than anxiety symptoms alone.

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“…However, the degree of control of the CVRF in patients with IHD is low [15]–[17], which results in a higher use of health services. The frequency of primary care visits of a person with diabetes in Spain is 28 per year, even though this does not necessarily imply greater control [21].…”

Section: Discussionmentioning

confidence: 99%

“…However, improvement was only found in blood pressure control and an increase in HDL-cholesterol concentrations [14]. The PREseAP study assessed the efficacy of an intervention carried out by nurses, but with no positive results [16,17]. Another intervention study also from primary care [18] found that admissions to hospital were significantly reduced, but no other clinical benefits were shown, possibly because of a ceiling effect related to improved management of the disease.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial

Orozco-Beltrán

Ruescas-Escolano

Navarro-Palazón

et al. 2013

BMC Health Serv Res

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BackgroundTo evaluate the effectiveness of a new multifactorial intervention to improve health care for chronic ischemic heart disease patients in primary care. The strategy has two components: a) organizational for the patient/professional relationship and b) training for professionals.Methods/designExperimental study. Randomized clinical trial. Follow-up period: one year. Study setting: primary care, multicenter (15 health centers). For the intervention group 15 health centers are selected from those participating in ESCARVAL study. Once the center agreed to participate patients are randomly selected from the total amount of patients with ischemic heart disease registered in the electronic health records. For the control group a random sample of patients with ischemic heart disease is selected from all 72 health centers electronic records.Intervention components: a) Organizational intervention on the patient/professional relationship. Centered on the Chronic Care Model, the Stanford Expert Patient Program and the Kaiser Permanente model: Teamwork, informed and active patient, decision making shared with the patient, recommendations based on clinical guidelines, single electronic medical history per patient that allows the use of indicators for risk monitoring and stratification. b) Formative strategy for professionals: 4 face-to-face training workshops (one every 3 months), monthly update clinical sessions, online tutorial by a cardiologist, availability through the intranet of the action protocol and related documents.Measurements: Blood pressure, blood glucose, HbA1c, lipid profile and smoking. Frequent health care visits. Number of hospitalizations related to vascular disease. Therapeutic compliance. Drug use.DiscussionThis study aims to evaluate the efficacy of a multifactorial intervention strategy involving patients with ischemic heart disease for the improvement of the degree of control of the cardiovascular risk factors and of the quality of life, number of visits, and number of hospitalizations.Trial registrationNCT01826929

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Ensayo clínico aleatorizado para evaluar la eficacia de un programa integral de prevención secundaria de las enfermedades cardiovasculares en atención primaria: estudio PREseAP

Cited by 28 publications

References 17 publications

Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study

Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study

Association between anxiety and mortality in patients with coronary artery disease: A meta-analysis

Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial

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