Adequacy of the Indication of Lipid Lowering Treatment in Primary Prevention
Condition: Cardiovascular Diseases
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      OBJECTIVE: To evaluate the impact of an intervention addressed to health professionals to
      improve the adequacy of lipid-lowering prescription in primary prevention of cardiovascular
      disease and reducing expenditure in this respect.

      DESIGN: a cluster randomized clinical trial, not blind; Data were obtained from medical
      records and other primary care databases.

      SETTING: 279 primary health care teams in Catalonia (Spain), centers managed by Catalan
      Health Institute (ICS)

      SUBJECTS: Population from 35 to 74 years, free of cardiovascular disease, who have been
      started on lipid-lowering therapy during 2 consecutive years of study.

      INTERVENTION: Practitioners in the intervention group may have access, whenever they want and
      through the computerized medical record program, to personalized information on their
      assigned patients who have started treatment of cardiovascular primary prevention with
      lipid-lowering. This information is updated monthly for 12 consecutive months.Information
      will be presented in two different and complementary ways to each practitioner: asynchronous
      information (the patient is not present when the practitioner receives the information) and
      synchronous information (the patient is present when the practitioner receives the
      information).

      VARIABLES:

        1. Primary Outcomes are:

             -  Variable RETIRA: new lipid-lowering treatments initiated during the year prior to
                the intervention, seen as inadequate and withdrawn during the intervention period.

             -  Variable EVITA: New lipid-lowering treatments started during the intervention
                period and considered as inadequate.

        2. Secondary Outcomes are:

             -  Variable COST: total cost of the inadequate new lipid-lowering treatments.

             -  Variable RECORD: recording of the cardiovascular risk.

      2.Other variables:

        -  Principal: intervention/control group assignment of health professional.

        -  Patient variables: demographic and clinical.

        -  Professional variables: quality of care indicators.

      STATISTICAL ANALYSIS: Descriptive analysis, agreggated at health professional level, will be
      performed and subsequently multilevel analysis techniques will be used to estimate the effect
      of intervention according to hierarchic data structure and, in particular, patient variables
      effect.
    


Intervention name(s): Information Support System
Intervention type(s): Other
Intervention description(s): Practitioners in the intervention group may have access, whenever they want and through the computerized medical record program, to personalized information on their assigned patients who have started treatment of cardiovascular primary prevention with lipid-lowering. This information is updated monthly for 12 consecutive months.Information will be presented in two different and complementary ways to each practitioner: asynchronous information (the patient is not present when the practitioner receives the information) and synchronous information (the patient is present when the practitioner receives the information).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Primary Care; Lipid-lowering therapy; Prescription; Adequacy; Primary prevention; Cardiovascular diseases; Electronic Medical records; Clinical Practice Guideline