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Open AccessArticle

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

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Equip d’Atenció Primària Tortosa Oest, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Chair of Family Medicine, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
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Unitat de Suport a la Recerca Terres de l’Ebre, Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi Gol, 43500 Tortosa, Tarragona, Spain
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Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Fundació Institut Català de Farmacologia, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
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Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(6), 1233; https://doi.org/10.3390/ijerph15061233
Received: 10 April 2018 / Revised: 31 May 2018 / Accepted: 7 June 2018 / Published: 11 June 2018
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. View Full-Text
Keywords: cardiovascular disease; secondary prevention; primary health care; health systems cardiovascular disease; secondary prevention; primary health care; health systems
MDPI and ACS Style

Pepió Vilaubí, J.M.; Orozco-Beltrán, D.; Gonçalves, A.Q.; Rodriguez Cumplido, D.; Aguilar Martin, C.; Lopez-Pineda, A.; Gil-Guillen, V.F.; Quesada, J.A.; Carratala-Munuera, C. Adherence to European Clinical Practice Guidelines for Secondary Prevention of Cardiovascular Disease: A Cohort Study. Int. J. Environ. Res. Public Health 2018, 15, 1233.

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