[Improved effectiveness in the management of cardiovascular risk among type 2 diabetic patients in primary health care].
OBJECTIVE
To determine the impact of the implementation of a guidelines in the assessment of cardiovascular risk in high-risk patients (type 2 diabetes) in health centres, and to analyse the appropriateness of antihypertensive and antiplatelet treatment in diabetic patients.


METHODS
Quasi-experimental, non-randomised, prospective study with concurrent control group. PLACEMENT: Two health centres in Málaga.


METHODS
General practitioners of the two centres.


METHODS
The guideline was implemented through a multifaceted intervention in family physicians in the experimental centre.


RESULTS
Rate of cardiovascular risk assessment in high risk population. Secondary: appropriateness of antihypertensive and antiplatelet treatment.


RESULTS
Large differences were detected in the cardiovascular risk assessment, improving in the experimental group (74.36% vs. 7.63%; RR = 9.74; 95% CI, 5.15-18.43; P = .0001). Similarly, the antiplatelet use was more in line with the guidelines recommendations in the intervention group (51.28% vs. 36.44%; RR = 1.407; 95% CI, 1.04-1.89; P = .026), and in antihypertensive drugs, although with no statistical significance (80% vs. 66.27%; RR = 1.207; 95% CI, 0.99-1.46).


CONCLUSIONS
A multifaceted intervention for the implementation of a guideline for the management of high risk cardiovascular patients, improves the adherence to effective interventions by family physicians.
Hormigo Pozo
Antonio
A
Centro de Salud Puerta Blanca, Distrito Sanitario Málaga, Málaga, España. cpuertablanca@hotmail.com
Viciana López
María Angeles
MA
Gómez Jiménez
Leonor
L
Gallego Parrilla
María Dolores
MD
Orellana Lozano
Javier
J
Morales Asencio
José Miguel
JM
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011320:Primary Health Care; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors