OBJECTIVE: To evaluate the durability of the effects achieved with a quality improvement intervention on cardiovascular risk factors and cardiovascular risk, as intermediate outcomes, in hypertensive patients on long-term follow-up long time primary health care. DESIGN: Quasi-experimental study. SETTING:Two urban primary care health centres. PARTICIPANTS: The study included 419 and 430 hypertensive patients in the intervention (IG) and control group (CG), respectively. INTERVENTIONS:Quality improvement intervention consisted of a combined program including, an audit, feedback, training sessions on the main cardiovascular risk factors clinical guidelines. MEASUREMENTS: Evaluation of intermediate outcomes (blood pressure, LDL-cholesterol, HbA(1c), smoking, BMI and cardiovascular risk), were measured in both groups in March 2002, 2004 and 2006. RESULTS: The mean of the durability effect (differences between IG and CG means) was: systolic blood pressure decreased from 8.9 to 4.3 and the diastolic from 3.9 to 2.3 mmHg (p<0.05). LDL-cholesterol decreased from 10 to 1.1mg/dl (p>0.05). Coronary risk fell from 2 to 1.2 percentage points and cardiovascular mortality risk from 0.6 to 0.4 percentage points (p<0.05). The percentage of patients with blood pressure<140/90 mmHg and BMI<30 lost statistical significance in the end evaluation and only remains in the percentage of patients with coronary risk less than 20% in the 2004 and 2006 results. CONCLUSIONS:Quality improvement intervention was associated with reductions in cardiovascular risk factors and cardiovascular risk in post intervention evaluations with a tendency to decrease the effect achieved in the end evaluation.
RCT Entities:
OBJECTIVE: To evaluate the durability of the effects achieved with a quality improvement intervention on cardiovascular risk factors and cardiovascular risk, as intermediate outcomes, in hypertensivepatients on long-term follow-up long time primary health care. DESIGN: Quasi-experimental study. SETTING: Two urban primary care health centres. PARTICIPANTS: The study included 419 and 430 hypertensivepatients in the intervention (IG) and control group (CG), respectively. INTERVENTIONS: Quality improvement intervention consisted of a combined program including, an audit, feedback, training sessions on the main cardiovascular risk factors clinical guidelines. MEASUREMENTS: Evaluation of intermediate outcomes (blood pressure, LDL-cholesterol, HbA(1c), smoking, BMI and cardiovascular risk), were measured in both groups in March 2002, 2004 and 2006. RESULTS: The mean of the durability effect (differences between IG and CG means) was: systolic blood pressure decreased from 8.9 to 4.3 and the diastolic from 3.9 to 2.3 mmHg (p<0.05). LDL-cholesterol decreased from 10 to 1.1mg/dl (p>0.05). Coronary risk fell from 2 to 1.2 percentage points and cardiovascular mortality risk from 0.6 to 0.4 percentage points (p<0.05). The percentage of patients with blood pressure<140/90 mmHg and BMI<30 lost statistical significance in the end evaluation and only remains in the percentage of patients with coronary risk less than 20% in the 2004 and 2006 results. CONCLUSIONS: Quality improvement intervention was associated with reductions in cardiovascular risk factors and cardiovascular risk in post intervention evaluations with a tendency to decrease the effect achieved in the end evaluation.
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Authors: A de la Peña Fernández; B Roca Villanueva; I Cuende Melero; J R Calabuig Alborch; J Montes Santiago; M Muñoz Rodríguez; M Piedracausa Selfa; C Suárez Fernández Journal: Rev Clin Esp Date: 2007-03 Impact factor: 1.556
Authors: José L Llisterri Caro; Gustavo C Rodríguez Roca; Francisco J Alonso Moreno; Salvador Lou Arnal; Juan A Divisón Garrote; José A Santos Rodríguez; Anna Raber Béjar; Rous de Castellar Sansó; Luis M Ruilope Urioste; José R Banegas Banegas Journal: Med Clin (Barc) Date: 2004-02-14 Impact factor: 1.725
Authors: José L Llisterri Caro; Gustavo C Rodríguez Roca; Francisco J Alonso Moreno; José R Banegas Banegas; Diego González-Segura Alsina; Salvador Lou Arnal; Juan A Divisón Garrote; Tomás Sánchez Ruiz; José A Santos Rodríguez; Vivencio Barrios Alonso Journal: Med Clin (Barc) Date: 2008-05-17 Impact factor: 1.725