[Evaluation of the implementation of clinical guidelines in the Basque Country. Cluster randomized trial]

Etxeberria A, Rotaeche R, Pérez I, Alcorta I, Emparanza JI, Ruiz de Velasco E, Iglesias M, Reviriego E
Record ID 32018000578
Spanish
Original Title: Evaluación de la implementación de guías clínicas en el País Vasco. Ensayo aleatorizado por grupos
Authors' objectives: To evaluate the effectiveness, via process indicators and outcome, of a multifactorial intervention in the implementation of three cardiovascular risk-related CPGs (hypertension, type 2 diabetes and lipids as cardiovascular risk factors) in primary care (AP) in the Basque Health Service (Osakidetza) compared with the standard intervention implementation.
Authors' results and conclusions: This multifactorial intervention aimed at health-care professionals has shown an uneven effect as regards modification of the indicators contained in the guidelines, being more effective for the indicators contained in the lipidrelated guidelines. It has been shown to be effective in increasing CR screening in the healthy population and in diabetic and hypertensive patients, and in reducing the prescribing of statins in women with no ischaemic heart disease or diabetes. In contrast, it has been shown to be ineffective in improving patients’ clinical parameters (blood pressure and HbA1c). These findings could have various explanations, including the type of intervention (educational or aimed at professionals), the pragmatic design of the study, the patients’ baseline data being better than expected or the structuring of interventions around the novel CR concept. Nevertheless, the results provide important clues as regards the planning of future interventions to improve cardiovascular risk factors or diabetes.
Authors' methods: Study type: clinical trial randomized by groups («clusters») in two districts of the Osakidetza AP (Ekialde and Bilbao)Study population: All primary care units (PMU) in both districts were randomized, and all patients with diabetes, hypertension and those susceptible to Coronary Risk (CR) screening seen during the year prior to the intervention, and during the year following it, were assessed.
Details
Project Status: Completed
Year Published: 2012
URL for published report: https://www.euskadi.eus/contenidos/informacion/2013_osteba_publicacion/es_def/adjuntos/Implementacion%20guias_WEB.PDF
English language abstract: An English language summary is available
Publication Type: Other
Country: Spain
MeSH Terms
  • Cardiovascular Diseases
  • Diabetes Mellitus
  • Diabetes Mellitus, Type 2
  • Hypertension
  • Hypercholesterolemia
  • Hyperlipidemias
  • Lipids
  • Practice Guidelines as Topic
  • Guideline Adherence
Keywords
  • Cluster Analysis
  • Pragmatic Clinical Trials
  • Outcome and Process Assessment
  • Practice Guideline
  • Cardiovascular Diseases
  • Diabetes Mellitus
  • Hypertension
  • Lipids
  • Lípidos
  • Hipertensión
  • Diabetes
  • Enfermedades Cardiovasculares
  • Guías de Práctica Clínica
  • Evaluación de Procesos y Resultados
  • Ensayos Clínicos Pragmáticos
  • Análisis por Conglomerados
Contact
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: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government
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.