[Effectiveness of the protocols on cardiovascular risks in the Basque Country].
OBJECTIVE
To find the effectiveness of clinical protocols in detecting and monitoring the most important cardiovascular risk factors: tobacco dependency, high blood pressure, hyperlipaemia and diabetes mellitus.


METHODS
Cross-sectional descriptive study.


METHODS
Primary care centres in the Basque Country.


METHODS
1485 clinical histories of users aged between 40 and 75 who had attended for consultation over the previous two years, registered with general practitioners in the Basque Country who normally use clinical histories.


RESULTS
A questionnaire was sent to the people in charge of the 103 hierarchically organised centres requesting information on the use of protocols to detect and monitor the problems studied, and copies of protocols were requested. 77 centres (76%) replied and 66 sent 170 protocols. 990 clinical histories of doctors who used the four protocols and 495 of doctors who used none were analysed. These clinical histories belonged to lists of 45 doctors from 22 centres, chosen at random and stratified by whether their centre is registered with the PAPPS (preventive programme) or is a family and community medicine teaching centre. The centres using protocols were better at detecting tobacco dependency (24.6% vs 11.9%--p < 0.0005), hyperlipaemia (61.8% vs 53.1%--p < 0.001) and diabetes mellitus (75% vs 66.1%--p < 0.0005). The difference was less in the case of high blood pressure: 56.8% vs 52.1% (p = 0.097). No differences in quality in the monitoring of these problems were found.


CONCLUSIONS
The use of cardiovascular risk protocols by primary care centres is related to an improvement in the quality of cardiovascular risk detection, although not of its control.
Casi Casanellas
A
A
Unidad de Atención Primaria La Habana, Vitoria-Gasteiz. quasy@euskalnet.net
Aizpuru Barandiarán
F
F
Ibáñez Pérez
F
F
Múgica Campos
J
J
Torrabadella Luna
S
S
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control*; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000628:therapy; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013030:Spain