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Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol
Eva Comin1, Arantxa Catalán-Ramos, Jose M Verdu
1Institut Català de la Salut, Barcelona Spain. 16318ecb@comb.cat
Insights
This study evaluates electronic clinical practice guidelines (e-CPGs) in managing hypercholesterolaemia, diabetes, and hypertension. The findings will demonstrate e-CPG effectiveness in improving clinical decisions and evidence-based medicine in primary care.
Area of Science:
- Health Informatics
- Primary Care Medicine
- Clinical Decision Support
Background:
- The Catalan Institute of Health integrated electronic clinical practice guidelines (e-CPGs) into its electronic medical records system.
- This initiative aims to enhance the management of chronic conditions within primary care settings.
Purpose of the Study:
- To assess the impact of implementing e-CPGs on the diagnosis, treatment, control, and management of hypercholesterolaemia, diabetes mellitus type 2, and hypertension.
- To evaluate the effectiveness of e-CPGs in improving clinical decisions and healthcare procedures for these prevalent chronic diseases.
Main Methods:
- A controlled before-and-after study with 1-year follow-up analyzing routinely collected data from electronic primary care registries.
- Participants aged 35-74 years were assigned to either an intervention group (FPs regularly using e-CPGs) or a control group (FPs not regularly using e-CPGs).
- Outcomes measured include diagnosis accuracy, clinical variable control, test ordering patterns, and appropriate medication prescription rates.
Main Results:
- The study protocol establishes a reproducible method for evaluating the impact of e-CPG implementation.
- Anticipated results, expected in late 2013, will quantify the effects of e-CPGs on patient care.
Conclusions:
- The project will determine the effectiveness of e-CPGs in enhancing clinical practice for hypercholesterolaemia, diabetes mellitus type 2, and hypertension.
- Results are expected to provide insights into leveraging evidence-based medicine through e-CPGs to improve primary care physician practices.
Background:
The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs). This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension.
Methods:
Eligible study participants are those aged 35-74 years assigned to family practitioners (FPs) of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1) a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2) a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1) suspected and confirmed diagnoses, (2) control of clinical variables, (3) requests for tests and (4) proportions of patients with adequate drug prescriptions.
Results:
This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013.
Conclusion:
This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.
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