Author, as appears in the article.: Drago EF; Llorca MRD; Martín CA; Ferreira-González I; Rojas ZH; Gonçalves AQ; López-Pablo C
Department: Infermeria
URV's Author/s: Lopez Pablo, Carlos
Keywords: Secondary prevention Primary health care Practice guideline Ischemic heart disease Health-professions Cholesterol sex secondary prevention primary health care ischemic heart disease coronary cholesterol adherence
Abstract: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Cardiovascular diseases (CVD) are the main cause of death worldwide. The control of CVD risk factors, such as dyslipidemia, reduces their mortality rate. Nonetheless, fewer than 50% of patients with ischemic heart disease (IHD) have good cholesterol control. Our objective is to assess whether the level of participation of general practitioners (GPs) in activities to implement a dyslipidemia management guideline, and the characteristics of the patient and physician are associated with cholesterol control in IHD patients. We undertook a quasi-experimental, uncontrolled, before-and-after study of 1151 patients. The intervention was carried out during 2010 and 2011, and consisted of a face-to-face training and online course phase (Phase 1), and another of face-to-face feedback (Phase 2). The main outcome variable was the low-density lipoprotein cholesterol (LDL-C) control, whereby values of <100 mg/dL (2.6 mmol/L) were set as a good level of control, according to the recommendations of the guidelines in force in 2009. After Phase 1, 6.7% more patients demonstrated good cholesterol control. With respect to patient characteristics, being female and being older were found to be risk factors of poor control. Being diabetic and having suffered a stroke were protective factors. Of the GPs’ characteristics, being tutor in a teaching center for GP residents and having completed the online course were found to be protective factors. We concluded that cholesterol control in IHD patients was influenced by the type of training activity undertook by physicians during the implementation of the GPC, and patient and physician characteristics. We highlight that if we apply the recent targets of the European guideline, which establish a lower level of LDL-C control, the percentage of good control could be worse than the observed in this study.
Thematic Areas: Zootecnia / recursos pesqueiros Serviço social Saúde coletiva Química Public, environmental & occupational health Public health, environmental and occupational health Psicología Pollution Odontología Nutrição Medicina iii Medicina ii Medicina i Materiais Interdisciplinar Health, toxicology and mutagenesis Geografía Geociências Farmacia Environmental studies Environmental sciences Ensino Engenharias ii Engenharias i Enfermagem Educação física Educação Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Ciências agrárias i Ciência da computação Biotecnología Biodiversidade Astronomia / física Administração pública e de empresas, ciências contábeis e turismo
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: carlos.lopez@urv.cat
Author identifier: 0000-0003-1248-3065
Record's date: 2023-08-05
Papper version: info:eu-repo/semantics/publishedVersion
Link to the original source: https://www.mdpi.com/1660-4601/17/22/8590
Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: International Journal Of Environmental Research And Public Health. 17 (22): 1-15
APA: Drago EF; Llorca MRD; Martín CA; Ferreira-González I; Rojas ZH; Gonçalves AQ; López-Pablo C (2020). Impact of implementing a dyslipidemia management guideline on cholesterol control for secondary prevention of ischemic heart disease in primary care. International Journal Of Environmental Research And Public Health, 17(22), 1-15. DOI: 10.3390/ijerph17228590
Article's DOI: 10.3390/ijerph17228590
Entity: Universitat Rovira i Virgili
Journal publication year: 2020
Publication Type: Journal Publications
Repositori URV