Impact of the implementation of electronic guidelines for
cardiovascular prevention in primary care: study protocol

Comín, E.; Catalán-Ramos, Arantxa; Verdú, José María; Iglesias-Rodal, Manuel; García, José Luis del Val; Grau, María; Amado, Ester; Pons, Angels; Consola, Alicia; Ciurana, Ramon; Franzi, Alicia; Mata, Manel; Davins, Josep; Cos, Xavier; Frigola, Eva

doi:10.14236/jhi.v20i2.33

Cited by 5 publications

(4 citation statements)

References 33 publications

(39 reference statements)

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“…The 13 deimplementation strategies that have emerged from these performed structured and theory-informed processes are all "old known" strategies and interventions. Speci cally, in the context of the reduction in the prescription of low-value statins, a certain effectiveness of dissemination strategies, informative web pages, and the implementation of electronic clinical practice guidelines has been observed, compared with routine practice [30][31][32][33][34]. However, dissemination strategies such as educational or training actions for professionals (webinars and workshops) were not effective by themselves, only when used as multicomponent strategies, combining workshops and informative web pages [30,31].…”

Section: Discussionmentioning

confidence: 99%

Mapping De-Implementation Strategies To Identified Determinants of Low-Value Statin Prescription for Primary CVD Prevention in Primary Care

Sánchez

Elizondo-Alzola

Pijoán

et al. 2021

Preprint

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BackgroundDespite clear recommendations supporting healthy lifestyle promotion interventions for the primary prevention of CVD in low-risk patients, a considerable number of these people continue to receive inappropriate statin prescriptions. The present study reports on the structured process based on theory and evidence carried out for the design of de-implementation strategies to reduce the inappropriate prescription of statins and to increase the promotion of healthy lifestyles, in CVD prevention practice of primary care professionals for patients with low cardiovascular risk.MethodsA phase I formative study following a structured theory-informed process combining the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW) was conducted, comprising: semi-structured interviews (n=5) with primary care professionals to delimitate and define the problem in behavioral terms; focus groups (4 groups with 21 physicians; 1 group with 6 patients) to identify the determinants of potentially inappropriate prescribing [PIP] of statins and healthy lifestyle promotion actions; mapping of behavioral change interventions operationalized as de-implementation strategies for addressing identified determinants; and consensus techniques for the prioritization of strategies based on perceived effectiveness, feasibility and acceptability.ResultsNumerous multilevel determinants of both PIP of statins and healthy lifestyle promotion embracing almost all of the TDF dimensions have been identified. Guided by the BCW established procedure, 13 potential de-implementation strategies have been mapped to identified determinants. Those assessed as potentially more feasible, acceptable and potentially effective by the professionals themselves were: 1) Information/knowledge dissemination strategies: a corporate dissemination campaign on “Abandonment of Low-Value Practices”; a Clinical Pathway for the primary prevention of CVD in low-risk patients, accompanied with audiovisual and paper-based training resources; 2) Strategies for presenting relevant information for decision-making: an audit/feedback system regarding CVD prevention practice performance indicators; and 3) Strategies for helping clinical decisions: reminders, alerts, and a decision support tool incorporated into the REGICOR CVD risk calculator in the electronic clinical record.DiscussionThe methodology established by the TDF/BWC for the design of behavior change interventions has been useful for the development of de-implementation strategies targeting the decision-making process of clinicians to favor the uptake of recommended clinical practice for CVD prevention in low-risk patients.TRIAL REGISTRATIONClinicaltrials.gov identifier: NCT04022850. Registered 17 July 2019, https://www.clinicaltrials.gov/ct2/show/NCT04022850

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Section: Discussionmentioning

confidence: 99%

Mapping De-Implementation Strategies To Identified Determinants of Low-Value Statin Prescription for Primary CVD Prevention in Primary Care

Sánchez

Elizondo-Alzola

Pijoán

et al. 2021

Preprint

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“…We conducted a before-after controlled study to ascertain the impact of eCPG implementation. The study protocol, and the prevalence and control of cardiovascular risk factors have been described elsewhere 17, 18…”

Section: Methodsmentioning

confidence: 99%

“…Variables were collected according to a standardized methodology described elsewhere 17 . The information source was the ECAP database.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2017

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“…18,19 Relevant to this gap in the evidence our next paper is a protocol for the investigation of the impact of e-guidelines for cardiovascular prevention in primary care. 20 The final paper in this issue is another pilot, where investigators have just got on and used simple, readily available IT easily and cheaply. In this case they used iPads to run a video conferenced interpreter service.…”

Section: Supporting Better Decisionsmentioning

confidence: 99%

The health information ecosystem, technology to support more effective hospital discharge, data quality enables prediction of outcomes, and supporting better decision making

Lusignan

2013

Journal of Innovation in Health Informatics

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Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

Abstract: 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.

Cited by 5 publications

References 33 publications

Mapping De-Implementation Strategies To Identified Determinants of Low-Value Statin Prescription for Primary CVD Prevention in Primary Care

Mapping De-Implementation Strategies To Identified Determinants of Low-Value Statin Prescription for Primary CVD Prevention in Primary Care

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

The health information ecosystem, technology to support more effective hospital discharge, data quality enables prediction of outcomes, and supporting better decision making

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