Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.
OBJECTIVE
To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus.


METHODS
Pre-post controlled study.


METHODS
Catalonia, autonomous community located in north-eastern Spain.


METHODS
Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute.


METHODS
The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform.


RESULTS
The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively.


RESULTS
A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes.


CONCLUSIONS
Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear.
Institut Català de la Salut, Barcelona, Spain.
Eva
E
Comin
Agència de Qualitat i Avaluació Sanitàries de Catalunya, Barcelona, Spain.
Arantxa
A
Catalan-Ramos
Institut Català de la Salut, Barcelona, Spain.
Manuel
M
Iglesias-Rodal
Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Universitat de Barcelona, Spain. Electronic address: mgrau@imim.es.
Maria
M
Grau
Institut Català de la Salut, Barcelona, Spain; Institut d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain.
Jose Luis
JL
Del Val
Aplicaciones en Informática Avanzada (AIA), Barcelona, Spain.
Alicia
A
Consola
Institut Català de la Salut, Barcelona, Spain.
Ester
E
Amado
Institut Català de la Salut, Barcelona, Spain.
Angels
A
Pons
Institut Català de la Salut, Barcelona, Spain.
Manel
M
Mata-Cases
Institut Català de la Salut, Barcelona, Spain.
Alicia
A
Franzi
Institut Català de la Salut, Barcelona, Spain.
Ramon
R
Ciurana
Avedis Donabedian University Institute, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
Eva
E
Frigola
Institut Català de la Salut, Barcelona, Spain.
Xavier
X
Cos
Subdirecció General de Serveis Sanitaris, Departament de Salut, Barcelona, Spain.
Josep
J
Davins
Institut Català de la Salut, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain.
Jose M
JM
Verdu-Rotellar
Clinical practice guidelines; Diabetes mellitus tipo 2; Electronic health records; Evidence-based practice; Guías de práctica clínica; Hipercolesterolemia; Hipertensión; Historia clínica electrónica; Hypercholesterolemia; Hypertension; Práctica basada en la evidencia; Type 2 diabetes mellitus