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Fam Pract. 2015 Dec;32(6):672-80. doi: 10.1093/fampra/cmv038. Epub 2015 Jun 18.

Barriers to improved dyslipidemia control: Delphi survey of a multidisciplinary panel.

Author information

1
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, atencion.primaria@umh.es.
2
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante.
3
Family Medicine, Manises Primary Health Care Center, Valencia Health Agency, Valencia.
4
Family Medicine, Sardoma Primary Health Care Center, Galician Health Service, Vigo.
5
Family Medicine, Jazmin Primary Health Care Center, Madrid.
6
Research Unit, Sardenya Primary Health Care Center, Biomedical Research Institute Sant Pau, Barcelona.
7
Family Medicine, Fuensanta Clinical Management Unit, Reina Sofia Hospital, IMIBIC and Cordoba University, Cordoba and.
8
Family Medicine, La Calzada II Primary Health Care Center, Gijon, Spain.

Abstract

OBJECTIVE:

To assess the barriers that make it difficult for the health care professionals (physicians, nurses and health care managers) to achieve a better control for dyslipidemia in Spain.

METHODS:

The study has an observational design and was performed using the modified Delphi technique. One hundred and forty-nine panel members from medicine, nursing and health care management fields and from different Spanish regions were selected randomly and were invited to participate. Individual and anonymous opinions were asked by answering a 42-items questionnaire via e-mail (two rounds were done). Level of agreement was assessed using measures of central tendency and dispersion. We analysed commonalities/differences between the three groups (Kappa index and McNemar chi-square).

RESULTS:

Response rate: 81%. The agreement index was 33.3 (95% CI: 18.9-47.7). Regarding the non-compliance with therapy, it improves with patient education degree in dyslipidemia, patient motivation, the agreement on decisions with the patient and with the use of cardiovascular risk measure and it gets worse with lack of information on the objectives to achieve. Clinical inertia improves with professional's motivation, cardiovascular risk calculation, training on objectives and the use of indicators and it gets worse with lack of treatment goals.

CONCLUSION:

Different perceptions and attitudes between medicine, nursing and health care management were found. An agreement in interventions in non-compliance and clinical inertia to improve dyslipidemia control was reached.

KEYWORDS:

Cardiovascular disease; Delphi technique; family practice; hyperlipidemias; practice management; risk factors.

PMID:
26089296
DOI:
10.1093/fampra/cmv038
[Indexed for MEDLINE]

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