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Stepwise implementation of a cardiovascular risk management care program in primary care

BACKGROUND: Primary care plays a pivotal role in sustainable cardiovascular risk management (CVRM) but little is known about the organizational process of implementing the guidelines. The aim of the study was to describe the approach taken by a primary care group to implement the CVRM guideline. MET...

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Autores principales: Smits, Geert, Hollander, Monika, van Doorn, Sander, Bots, Michiel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746647/
http://dx.doi.org/10.1186/s12875-021-01602-w
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author Smits, Geert
Hollander, Monika
van Doorn, Sander
Bots, Michiel
author_facet Smits, Geert
Hollander, Monika
van Doorn, Sander
Bots, Michiel
author_sort Smits, Geert
collection PubMed
description BACKGROUND: Primary care plays a pivotal role in sustainable cardiovascular risk management (CVRM) but little is known about the organizational process of implementing the guidelines. The aim of the study was to describe the approach taken by a primary care group to implement the CVRM guideline. METHODS: Stepwise introduction and implementation of a programmatic CVRM care program was organized and facilitated by the care group between April 2010 and January 2013 in 137 affiliated general practices with 188 general practitioners (GPs), in the vicinity of Eindhoven, Netherlands. Care group support comprised sufficient staff, support with data extraction based on ICPC and ATC codes and with identification of eligible patients by scrutinizing patient health records and adequate coding of disease conditions. RESULTS: Patient selection based on availability of structured information on ICPC codes and risk factor levels from the electronic health records, led to 38,675 eligible patients in 2013. December 2019, the CVRM program was still running in 151 practices with 51,416 patients receiving programmatic CVRM care. Linking problems between 8 different electronic health record systems and the multidisciplinary information system for integrated care delayed adequate data collection until the beginning of 2013. CONCLUSION: Commitment of affiliated GPs, a structured approach with adequate coding of diagnoses and risk factors, central data registration and additional funding for sufficient staff support are important conditions for the introduction and implementation of successful and sustainable programmatic CVRM care. This approach constitutes the basis for long-term follow up and annual evaluation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-021-01602-w.
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spelling pubmed-87466472022-01-18 Stepwise implementation of a cardiovascular risk management care program in primary care Smits, Geert Hollander, Monika van Doorn, Sander Bots, Michiel BMC Prim Care Research Article BACKGROUND: Primary care plays a pivotal role in sustainable cardiovascular risk management (CVRM) but little is known about the organizational process of implementing the guidelines. The aim of the study was to describe the approach taken by a primary care group to implement the CVRM guideline. METHODS: Stepwise introduction and implementation of a programmatic CVRM care program was organized and facilitated by the care group between April 2010 and January 2013 in 137 affiliated general practices with 188 general practitioners (GPs), in the vicinity of Eindhoven, Netherlands. Care group support comprised sufficient staff, support with data extraction based on ICPC and ATC codes and with identification of eligible patients by scrutinizing patient health records and adequate coding of disease conditions. RESULTS: Patient selection based on availability of structured information on ICPC codes and risk factor levels from the electronic health records, led to 38,675 eligible patients in 2013. December 2019, the CVRM program was still running in 151 practices with 51,416 patients receiving programmatic CVRM care. Linking problems between 8 different electronic health record systems and the multidisciplinary information system for integrated care delayed adequate data collection until the beginning of 2013. CONCLUSION: Commitment of affiliated GPs, a structured approach with adequate coding of diagnoses and risk factors, central data registration and additional funding for sufficient staff support are important conditions for the introduction and implementation of successful and sustainable programmatic CVRM care. This approach constitutes the basis for long-term follow up and annual evaluation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-021-01602-w. BioMed Central 2022-01-05 /pmc/articles/PMC8746647/ http://dx.doi.org/10.1186/s12875-021-01602-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Smits, Geert
Hollander, Monika
van Doorn, Sander
Bots, Michiel
Stepwise implementation of a cardiovascular risk management care program in primary care
title Stepwise implementation of a cardiovascular risk management care program in primary care
title_full Stepwise implementation of a cardiovascular risk management care program in primary care
title_fullStr Stepwise implementation of a cardiovascular risk management care program in primary care
title_full_unstemmed Stepwise implementation of a cardiovascular risk management care program in primary care
title_short Stepwise implementation of a cardiovascular risk management care program in primary care
title_sort stepwise implementation of a cardiovascular risk management care program in primary care
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746647/
http://dx.doi.org/10.1186/s12875-021-01602-w
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