Implementation of Spanish adaptation of the European guidelines on cardiovascular disease prevention in primary care

BMC Family Practice

Research Article

Rosa Moreno¹  Juan Carlos Obaya²  Ana de Santiago³  Alberto Cordero⁴  Juan Pedro-Botet⁵  Vicenta Lizarbe⁶  Fernando Villar⁷  Olga Cortés Rico⁸  Roberto Elosua⁹  Susana Sans^1,10  José Maria Lobos^1,11  Antonio Maiques^1,12  Miguel Ángel Royo-Bordonada^1,13  Ángel Castellanos^1,14  Santiago Diaz^1,15  Irene Moral^1,16  Carlos Brotons^1,16  Francisco Fornés-Ubeda^1,17  Antonio Pérez^1,18  Miguel Camafort-Babkowski^1,19  Fernando de Álvaro-Moreno^2,20  Benilde Serrano-Saiz^2,21  Antonio Gil-Nuñez^2,22  Carmen de Pablo^2,23  Pedro Armario^2,24  Ángel Lizcano^2,25 

[1] Angiología y Cirugía Vascular, Hospital Universitario de la Princesa, Madrid, Spain;Chopera Primary Care Center, Health Regional Service (North Area), Madrid, Spain;Cogolludo Health Care Center, SESCAM, Guadalajara, Spain;Department of Cardiology, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain;Department of Medicine, Unidad Docente del IMAS, Hospital del Mar, Barcelona, Spain;Dirección General de Salud Pública, Calidad e Innovación, Ministerio de Sanidad, Servicios Sociales e Igualdad, Madrid, Spain;Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Universidad Autónoma de Madrid, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Health Care Center Canillejas, Madrid, Spain;Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain;Institut d’Estudis de la Salut, Barcelona, Spain;Jazmín Primary Health Care Center, Health Regional Service (East Area), Madrid, Spain;Manises Health Care Center, Valencia, Spain;National School of Public Health, Institute of Health Carlos III, Madrid, Spain;Periodistas Primary Health Care Center, Health Regional Service (North Area), Madrid, Spain;Pintores Primary Health Care Center, Health Regional Service (South Area), Madrid, Spain;Research Unit, Sardenya Primary Health Care Center-Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain;Salud Laboral de la Policía Local de Valencia, Valencia, Spain;Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;Servicio de Medicina Interna, ICMID, Hospital Clinic-IDIBAPS, Barcelona, Spain;Servicio de Nefrología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain;Sociedad Española de Medicina y Seguridad del Trabajo, Sociedad Castellana de Medicina y Seguridad del Trabajo, Madrid, Spain;Unidad de Ictus, Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, Spain;Unidad de Rehabilitación Cardiaca, Servicio Cardiología, Hospital Ramón y Cajal, Madrid, Spain;Unit of Hypertension and Vascular risk, Department of Internal Medicine, Hospital General de L’Hospitalet, University of Barcelona, Barcelona, Spain;Universidad Rey Juan Carlos, Madrid, Spain;

关键词: Cardiovascular disease;    Practice guidelines;    Risk assessment;    Primary care providers;    Implementation;   

DOI  :  10.1186/1471-2296-14-36

 received in 2012-10-16, accepted in 2013-03-12,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptation of the European guidelines on CVD prevention in clinical practice (CEIPC guidelines) among PCPs.MethodsA cross-sectional survey of PCPs was conducted in Spain between January and June 2011. A random sample of 1,390 PCPs was obtained and stratified by region. Data were collected by means of a self-administered questionnaire.ResultsMore than half (58%) the physicians were aware of and knew the recommendations, and 62% of those claimed to use them in clinical practice, with general physicians (without any specialist accreditation) being less likely to so than family doctors. Most PCPs (60%) did not assess cardiovascular risk, with the limited time available in the surgery being cited as the greatest barrier by 81%. The main reason to be sceptical about recommendations, reported by 71% of physicians, was that there are too many guidelines. Almost half the doctors cited the lack of training and skills as the greatest barrier to the implementation of lifestyle and behavioural change recommendations.ConclusionsMost PCPs were aware of the Spanish adaptation of the European guidelines on CVD prevention (CEIPC guidelines) and knew their content. However, only one third of PCPs used the guidelines in clinical practice and less than half CVD risk assessment tools.

【 授权许可】

CC BY   
© Brotons et al.; licensee BioMed Central Ltd. 2013