title: Construction and validation of a model to predict nonadherence to guidelines for prescribing antiplatelet therapy to hypertensive patients.
abstract: OBJECTIVE
  To construct and validate a model to predict nonadherence to guidelines for prescribing antiplatelet therapy (NGAT) to hypertensive patients.
  
  
  METHODS
  This 3 month prospective study was undertaken in 2007-2009 to determine whether 712 hypertensive patients were or were not being prescribed antiplatelet therapy.
  
  
  RESULTS
  NGAT according to clinical guidelines (just for patients in secondary prevention or with Systematic COronary Risk Evaluation (SCORE) ≥10%). Secondary variables: Duration of hypertension (years), blood pressure (BP), age, gender, smoking, diabetes, dyslipidemia, cardiovascular disease, lipid parameters, SCORE. Of the whole sample 80% was used to construct the model and 20% to validate it. To construct the model, we performed a multivariate logistic regression model which was adapted to be a scoring system with risk groups. The adjusted odds ratios (ORs) were obtained through the model. To validate the model we calculated the area under the ROC curve (AUC) and then compared the expected and the observed NGAT. The final model was adapted for use as a mobile application.
  
  
  RESULTS
  NGAT: 18.5%, construction; 17.9%, validation.
  
  
  METHODS
  higher duration of hypertension diagnosis, higher systolic BP, older age, male gender, smoking, diabetes, dyslipidemia and cardiovascular disease.
  
  
  RESULTS
  AUC = 0.82 (95% CI: 0.74-0.90, p < 0.001), with no differences between the observed and the expected NGAT (p = 0.334).
  
  
  CONCLUSIONS
  A tool was constructed and validated to predict NGAT. The associated factors were related with a greater cardiovascular risk. The scoring system has to be validated in other areas.
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palazón-Bru
authors.forename: Miguel José
authors.initials: MJ
authors.lastname: Martínez-Orozco
authors.forename: Zeneida
authors.initials: Z
authors.lastname: Perseguer-Torregrosa
authors.forename: Armina
authors.initials: A
authors.lastname: Sepehri
authors.forename: David Manuel
authors.initials: DM
authors.lastname: Folgado-de la Rosa
authors.forename: Domingo
authors.initials: D
authors.lastname: Orozco-Beltran
authors.forename: Concepción
authors.initials: C
authors.lastname: Carratalá-Munuera
authors.forename: Vicente Francisco
authors.initials: VF
authors.lastname: Gil-Guillén
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Hypertension; Models, statistical; Physicians; Platelet aggregation inhibitors; Primary health care