Adequacy of the Indication of Lipid Lowering Treatment in Primary Prevention

NCT ID: NCT01997671

Last Updated: 2013-12-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2013-09-30

Brief Summary

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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RETIRA: new lipid-lowering treatments initiated during the year prior to the intervention, seen as inadequate and withdrawn during the intervention period.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.

Detailed Description

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Conditions

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Cardiovascular Diseases

Keywords

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Primary Care Lipid-lowering therapy Prescription Adequacy Primary prevention Cardiovascular diseases Electronic Medical records Clinical Practice Guideline

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Information Support System

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.

Group Type EXPERIMENTAL

Information Support System

Intervention Type OTHER

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).

Control group

Routine clinical practice

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Information Support System

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).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Population from 35 to 74 years
* Free of cardiovascular disease
* Start on lipid-lowering therapy during 2 consecutive years of study

Exclusion Criteria

* Previous treatment with lipid-lowering
* History of cardiovascular disease
Minimum Eligible Age

35 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Preventive Services and Health Promotion Research Network

OTHER

Sponsor Role collaborator

Catalan Institute of Health

OTHER_GOV

Sponsor Role collaborator

Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bonaventura Bolíbar

Role: PRINCIPAL_INVESTIGATOR

Jordi Gol i Gurina Foundation - IDIAP Jordi Gol

Sebastià Calero

Role: STUDY_CHAIR

Catalan Institute of Health

Josep Casajuana

Role: STUDY_CHAIR

Catalan Institute of Health

Ermengol Coma

Role: STUDY_CHAIR

Catalan Institute of Health

Francesc Fina

Role: STUDY_CHAIR

Catalan Institute of Health

Mireia Fàbregas

Role: STUDY_CHAIR

Catalan Institute of Health

Eduardo Hermosilla

Role: STUDY_CHAIR

Jordi Gol i Gurina Foundation - IDIAP Jordi Gol

Manolo Medina

Role: STUDY_CHAIR

Catalan Institute of Health

Mònica Monteagudo

Role: STUDY_CHAIR

Jordi Gol i Gurina Foundation - IDIAP Jordi Gol

Rosa Morros

Role: STUDY_CHAIR

Jordi Gol i Gurina Foundation - IDIAP Jordi Gol

Magdalena Rosell

Role: STUDY_CHAIR

Jordi Gol i Gurina Foundation - IDIAP Jordi Gol

Locations

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IDIAP Jordi Gol

Barcelona, Barcelona, Spain

Site Status

Countries

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Spain

References

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Fabregas M, Berges I, Fina F, Hermosilla E, Coma E, Mendez L, Medina M, Calero S, Serrano E, Morros R, Monteagudo M, Bolibar B. Effectiveness of an intervention designed to optimize statins use: a primary prevention randomized clinical trial. BMC Fam Pract. 2014 Jul 15;15:135. doi: 10.1186/1471-2296-15-135.

Reference Type DERIVED
PMID: 25027229 (View on PubMed)

Other Identifiers

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EC11-342

Identifier Type: -

Identifier Source: org_study_id