RESUMO
OBJECTIVES: To determine the impact of the implementation of a guidelines in the assessment of cardiovascular risk in high-risk patients (type 2 diabetes) in health centres, and to analyse the appropriateness of antihypertensive and antiplatelet treatment in diabetic patients. DESIGN: Quasi-experimental, non-randomised, prospective study with concurrent control group. PLACEMENT: Two health centres in Málaga. PARTICIPANTS: General practitioners of the two centres. INTERVENTIONS: The guideline was implemented through a multifaceted intervention in family physicians in the experimental centre. MAIN OUTCOMES: Rate of cardiovascular risk assessment in high risk population. Secondary: appropriateness of antihypertensive and antiplatelet treatment. RESULTS: Large differences were detected in the cardiovascular risk assessment, improving in the experimental group (74.36% vs. 7.63%; RR = 9.74; 95% CI, 5.15-18.43; P = .0001). Similarly, the antiplatelet use was more in line with the guidelines recommendations in the intervention group (51.28% vs. 36.44%; RR = 1.407; 95% CI, 1.04-1.89; P = .026), and in antihypertensive drugs, although with no statistical significance (80% vs. 66.27%; RR = 1.207; 95% CI, 0.99-1.46). CONCLUSIONS: A multifaceted intervention for the implementation of a guideline for the management of high risk cardiovascular patients, improves the adherence to effective interventions by family physicians.