Adherence to evidence-based recommendations for chronic noncommunicable diseases: a multicenter cross-sectional study of Bogotá physicians
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| Format: | Artículo científico |
| Language: | en |
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Universidad Autónoma de Bucaramanga
2023
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| _version_ | 1876473536606896128 |
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| author | José David Cruz-Cuevas |
| author_facet | José David Cruz-Cuevas |
| contents | Adherence to evidence-based recommendations for chronic noncommunicable diseases: a multicenter cross-sectional study of Bogotá physicians José David Cruz-Cuevas Juan Carlos Villar Skarlet Marcell Vásquez Angélica María Moreno Felipe Ángel Rodríguez Medicina Evidence Based Medicine Internal Medicine Practice Guideline Primary Health Care Introduction. The management of patients with chronic noncommunicable diseases, when it follows evidence-based recommendations, improves clinical outcomes and health costs. Despite its importance, little is known about adherence to guidelines and the processes for its monitoring in our environment. The objective of this study was to report the applicability and adherence to a selection of recommendations from clinical practice guidelines for noncommunicable chronic diseases by doctors in Bogotá. Methods. This was a cross-sectional study, the baseline of a cluster experiment that assessed the impact of disseminating recommendations on seven chronic diseases to patients, caregivers, and physicians. A total of 177 physicians from public and private health institutions were invited. Consecutive samples of their medical records were manually reviewed in predefined time ranges (up to 20 patients per physician, with up to two diseases of interest). The proportions of applicability and adherence were calculated according to 40 recommendations. Results. The 177 physicians who participated (out of 266 eligible) were from seven institutions, and 3,747 medical records (21,093 patients/recommendation) were analyzed. The general applicability was 31.9% (95% CI 31.3-32.6%), and it varied considerably by recommendation (range 0.3-100%) and disease (range 10.7-65%). Overall adherence was 42.0% (95% CI 40.8-43.2%), with higher adherence in acute coronary syndrome patients (58.4%) and lower adherence in diabetes mellitus patients (23.7%). Discussion. This is the most up-to-date, exhaustive, and representative measurement of adherence to guideline recommendations by doctors in Bogotá. Conclusions. Adherence to evidence-based recommendations for patients with chronic noncommunicable diseases in Bogotá is poor and highly variable. 2023 artículo científico 0123-7047 https://www.redalyc.org/articulo.oa?id=71978168010 https://www.redalyc.org/journal/719/71978168010/ https://www.redalyc.org/journal/719/71978168010/html/ https://www.redalyc.org/journal/719/71978168010/71978168010.epub https://www.redalyc.org/journal/719/71978168010/movil https://doi.org/10.29375/01237047.4802 en http://www.redalyc.org/revista.oa?id=719 MedUNAB application/pdf Universidad Autónoma de Bucaramanga MedUNAB (Colombia) Num.2 Vol.26 |
| format | Artículo científico |
| id | redalyc_71978168010 |
| institution | Redalyc |
| language | en |
| publishDate | 2023 |
| publisher | Universidad Autónoma de Bucaramanga |
| spellingShingle | Adherence to evidence-based recommendations for chronic noncommunicable diseases: a multicenter cross-sectional study of Bogotá physicians José David Cruz-Cuevas Medicina Evidence Based Medicine Internal Medicine Practice Guideline Primary Health Care Adherence to evidence-based recommendations for chronic noncommunicable diseases: a multicenter cross-sectional study of Bogotá physicians José David Cruz-Cuevas Juan Carlos Villar Skarlet Marcell Vásquez Angélica María Moreno Felipe Ángel Rodríguez Medicina Evidence Based Medicine Internal Medicine Practice Guideline Primary Health Care Introduction. The management of patients with chronic noncommunicable diseases, when it follows evidence-based recommendations, improves clinical outcomes and health costs. Despite its importance, little is known about adherence to guidelines and the processes for its monitoring in our environment. The objective of this study was to report the applicability and adherence to a selection of recommendations from clinical practice guidelines for noncommunicable chronic diseases by doctors in Bogotá. Methods. This was a cross-sectional study, the baseline of a cluster experiment that assessed the impact of disseminating recommendations on seven chronic diseases to patients, caregivers, and physicians. A total of 177 physicians from public and private health institutions were invited. Consecutive samples of their medical records were manually reviewed in predefined time ranges (up to 20 patients per physician, with up to two diseases of interest). The proportions of applicability and adherence were calculated according to 40 recommendations. Results. The 177 physicians who participated (out of 266 eligible) were from seven institutions, and 3,747 medical records (21,093 patients/recommendation) were analyzed. The general applicability was 31.9% (95% CI 31.3-32.6%), and it varied considerably by recommendation (range 0.3-100%) and disease (range 10.7-65%). Overall adherence was 42.0% (95% CI 40.8-43.2%), with higher adherence in acute coronary syndrome patients (58.4%) and lower adherence in diabetes mellitus patients (23.7%). Discussion. This is the most up-to-date, exhaustive, and representative measurement of adherence to guideline recommendations by doctors in Bogotá. Conclusions. Adherence to evidence-based recommendations for patients with chronic noncommunicable diseases in Bogotá is poor and highly variable. 2023 artículo científico 0123-7047 https://www.redalyc.org/articulo.oa?id=71978168010 https://www.redalyc.org/journal/719/71978168010/ https://www.redalyc.org/journal/719/71978168010/html/ https://www.redalyc.org/journal/719/71978168010/71978168010.epub https://www.redalyc.org/journal/719/71978168010/movil https://doi.org/10.29375/01237047.4802 en http://www.redalyc.org/revista.oa?id=719 MedUNAB application/pdf Universidad Autónoma de Bucaramanga MedUNAB (Colombia) Num.2 Vol.26 |
| title | Adherence to evidence-based recommendations for chronic noncommunicable diseases: a multicenter cross-sectional study of Bogotá physicians |
| topic | Medicina Evidence Based Medicine Internal Medicine Practice Guideline Primary Health Care |
| url | https://www.redalyc.org/articulo.oa?id=71978168010 https://www.redalyc.org/journal/719/71978168010/ https://www.redalyc.org/journal/719/71978168010/html/ https://www.redalyc.org/journal/719/71978168010/71978168010.epub https://www.redalyc.org/journal/719/71978168010/movil https://doi.org/10.29375/01237047.4802 |