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dc.contributor.authorRodríguez-Salvanés, Francisco
dc.contributor.authorNovella, Blanca
dc.contributor.authorFernández Luque, María Jesús
dc.contributor.authorSanchez-Gomez, Luis Maria 
dc.contributor.authorRuiz-Díaz, Lourdes
dc.contributor.authorSánchez-Alcalde, Rosa
dc.contributor.authorSierra-García, Belén
dc.contributor.authorMayayo, Soledad
dc.contributor.authorRuiz-López, Marta
dc.contributor.authorLoeches, Pilar
dc.contributor.authorLópez-Gónzález, Javier
dc.contributor.authorGonzález-Gamarra, Amelia
dc.contributor.authorSIRVA2 group
dc.identifier.citationBMC Fam Pract. 2011; 12: 21.es_ES
dc.description.abstractThis 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. Trial Registration: NCT01270022 Keywords: Primary healthcare Randomised clinical trial, Cluster analysis, Clinical practice guidelines, Cardiovascular diseases_ES
dc.description.sponsorshipFunding 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.es_ES
dc.publisherBioMed Central (BMC) es_ES
dc.subjectPrimary healthcarees_ES
dc.subjectRandomised clinical triales_ES
dc.subjectCluster analysises_ES
dc.subjectClinical practice guidelineses_ES
dc.subjectCardiovascular diseasees_ES
dc.subject.meshPractice Guidelines as Topic es_ES
dc.subject.meshCardiovascular Diseases es_ES
dc.subject.meshCluster Analysis es_ES
dc.subject.meshCross-Sectional Studies es_ES
dc.subject.meshDouble-Blind Method es_ES
dc.subject.meshEducation, Medical, Continuing es_ES
dc.subject.meshFemale es_ES
dc.subject.meshFollow-Up Studies es_ES
dc.subject.meshHumans es_ES
dc.subject.meshInformation Dissemination es_ES
dc.subject.meshMale es_ES
dc.subject.meshMedical Records es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshPrimary Health Care es_ES
dc.subject.meshResearch Design es_ES
dc.subject.meshRisk Factors es_ES
dc.subject.meshSpain es_ES
dc.titleEfficacy 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 clusterses_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderPlan Nacional de I+D+i (España) es_ES
dc.identifier.journalBMC Family Practicees_ES
dc.repisalud.centroISCIII::Agencia de Evaluación de Tecnologías Sanitariases_ES
dc.rights.accessRightsopen accesses_ES

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Atribución 4.0 Internacional
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