Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study

oleh: Eva Comin, Arantxa Catalan-Ramos, Manuel Iglesias-Rodal, Maria Grau, Jose Luis del Val, Alicia Consola, Ester Amado, Angels Pons, Manel Mata-Cases, Alicia Franzi, Ramon Ciurana, Eva Frigola, Xavier Cos, Josep Davins, Jose M. Verdu-Rotellar

Format: Article
Diterbitkan: Elsevier 2017-08-01

Deskripsi

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. Design: Pre-post controlled study. Setting: Catalonia, autonomous community located in north-eastern Spain. Participants: Individuals aged 35–74 years assigned to general practitioners of the Catalan Health Institute. Intervention: 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. Main outcomes: 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.