[Analysis of the use of clinical protocols for monitoring the chronically ill in primary health care]

Casi A, Aizpuru F, Ibanez F
Record ID 32000001784
Original Title: Análisis de la utilización de protocolos clínicos para el control de enfermos crónicos en la atención primaria
Authors' objectives: The aim of this survey is to prepare a model that will allow an appraisal to be made of the general quality of Clinical Protocols (CP) in primary health care. It is also intended to determine the implementation and quality of the CPs used by Primary Health Care Units (PHCU) as well as their effectiveness in the detection and control of major cardiovascular risks such as an addition to tobacco, high blood pressure, hyperlipemia and diabetes mellitus.
Authors' results and conclusions: Firstly, a questionnaire was sent to officers responsible for 103 centres, which are organised hierarchically, requesting information on the use of CPs for the detection and control of the problems surveyed, as well as copies of these. Seventy-seven centres (75%) responded, of which 66 have sent a total of 170 CPs. Based on non specific proposals for primary health care, 21 quality criteria have been defined in order to make an appraisal of the CPs, grouped in 6 blocks. According to the model applied to the CPs, the greatest deficiencies have been observed in forecasting the conditions for their application (4%), in the bibliographical support for recommendations (19%), in the identification of the persons involved in the design (23%) and in measuring the impact (30%). - Secondly, an analysis has been made of 990 clinical histories of 45 doctors in 22 different centres, who use the four CPs and 495 doctors who use none, selected at random and stratified according to whether their centre is taking part in the preventive activities programme or to whether it is a postgraduate teaching centre for medicine.
Authors' recommendations: The CPs used by Primary Health Care Units show a low level of compliance with a number of quality criteria such as the bibliographical basis of their recommendations, predicting the conditions for their application, as well as the measurement of their impact. The use of CPs for cardiovascular risks by Primary Health Care Units is related to an improvement in the quality of their detection, but not with the quality of their control, once the diagnosis has been made.It is recommended to promote the preparation of quality CPs in order to enhance their effectiveness, adapt a procedure that can be used as a model for their design and include among the aims of the Primary Health Care Units, the compliance of CPs with quality criteria with respect to frequent health problems.
Authors' methods: This involves a transversal descriptive survey carried out in the Primary Health Care Units of the Autonomous Community of the Basque Country. PARTICIPANTS: An analysis has been made of the CPs used by Primary Health Care Units in handling the problems under study, as well as the information contained in the clinical histories of users aged between 40 and 75, who had sought medical attention during the two years previous to the survey, and who were assigned to Primary Health Care doctors in the Autonomous Community of the Basque Country, who use clinical histories on a regular basis.
Project Status: Completed
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Chronic Disease
  • Guidelines as Topic
Organisation Name: Basque Office for Health Technology Assessment
Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz
Contact Name: Lorea Galnares-Cordero
Contact Email: lgalnares@bioef.eus
Copyright: <p>Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.