Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study

Josep Maria Pepió Vilaubí, Domingo Orozco-Beltrán, Alessandra Queiroga Gonçalves, Dolors Rodriguez Cumplido, Carina Aguilar Martin, Adriana Lopez-Pineda, Vicente F. Gil-Guillen, Jose A. Quesada and Concepcion Carratala-Munuera
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Josep Maria Pepió Vilaubí: Equip d’Atenció Primària Tortosa Oest, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
Domingo Orozco-Beltrán: Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
Alessandra Queiroga Gonçalves: Unitat de Suport a la Recerca Terres de l’Ebre, Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi Gol, 43500 Tortosa, Tarragona, Spain
Dolors Rodriguez Cumplido: Fundació Institut Català de Farmacologia, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
Carina Aguilar Martin: Unitat de Suport a la Recerca Terres de l’Ebre, Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi Gol, 43500 Tortosa, Tarragona, Spain
Adriana Lopez-Pineda: Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
Vicente F. Gil-Guillen: Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
Jose A. Quesada: Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
Concepcion Carratala-Munuera: Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain

IJERPH, 2018, vol. 15, issue 6, 1-11

Abstract: To provide a better understanding of the actions taken within health systems and their results, this study aims to assess clinicians’ adherence to clinical practice guidelines (CPGs) regarding recommended treatments in patients with cardiovascular disease in primary care settings, and to determine the associated factors. We conducted an ambispective cohort study in 21 primary care centres in 8 Spanish regions. Patients diagnosed with coronary heart disease, stroke and/or peripheral arterial disease were included. Patients who received the treatment recommended in the European guidelines on cardiovascular disease prevention (CPG’s adherent group) were compared with patients who did not (CPG’s non-adherent group). The outcome variables were cardiovascular hospital admissions, all-cause and cardiovascular mortality during follow-up. Of the 438 participants, 38.6% ( n = 169) received the drug therapies recommended in the guidelines. The factors that increased the likelihood of good adherence to CPG’s were being diagnosed with hypertension (p = 0.001), dyslipidaemia ( p < 0.001) or diabetes ( p = 0.001), and not having a psychiatric disorder (p = 0.005). We found no statistically significant association between good adherence to CPG’s and lower incidence of events ( p = 0.853). Clinician adherence to guidelines for secondary prevention of cardiovascular disease was low in the primary care setting.

Keywords: cardiovascular disease; secondary prevention; primary health care; health systems (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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