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General practice / Family practice
Research
Intervention for control of hypertension in Catalonia, Spain (INCOTECA Project): results of a multicentric, non-randomised, quasi-experimental controlled intervention study
  1. Roser Vallès-Fernández1,
  2. Teresa Rodriguez-Blanco2,
  3. Lucas Mengual-Martínez3,
  4. Magdalena Rosell-Murphy4,
  5. Gemma Prieto-De Lamo4,
  6. Fina Martínez-Frutos5,
  7. Sonia Mimoso-Moreno5,
  8. Eva Bellerino-Serrano6,
  9. Alícia Àlvarez-Lázaro6,
  10. Alícia Franzi-Sisó7,
  11. Juan Carlos Martínez-Vindel8,
  12. Mª Socorro Alonso-Ortega8,
  13. Imma Olmedo-Muñoz9,
  14. Josep Mª Bonet-Simó1,
  15. the INCOTECA research group*
  1. 1Primary Care Service (SAP) Cerdanyola-Ripollet, Catalan Institute of Health (ICS), Cerdanyola del Vallès, Spain
  2. 2Primary Care Research Institute (IDIAP Jordi Gol) and Autonomous University of Barcelona (UAB), Barcelona, Spain
  3. 3Primary Care Team (EAP) Badia del Vallès. Catalan Institute of Health (ICS), Badia del Vallès, Spain
  4. 4Primary Care Research Institute (IDIAP Jordi Gol), Barcelona, Spain
  5. 5Primary Care Team (EAP) Canaletes-Fontetes, Catalan Institute of Health (ICS), Cerdanyola del Vallès, Spain
  6. 6Primary Care Team (EAP) Ripollet, Catalan Institute of Health (ICS), Ripollet, Spain
  7. 7Primary Care Service (SAP) Sabadell-Rubí-St, Cugat-Terrassa, Catalan Institute of Health (ICS), Sabadell, Spain
  8. 8Primary Care Team (EAP) Barberà, Catalan Institute of Health (ICS), Barberà del Vallès, Spain
  9. 9Primary Care Team (EAP) Serraparera, Catalan Institute of Health (ICS), Cerdanyola del Vallès, Spain
  1. Correspondence to Dr Roser Vallès Fernández; rvallesf{at}gencat.cat

Abstract

Objective The purpose of this study was to assess the effectiveness of a quality improvement (QI) plan aimed at primary healthcare teams (PHCTs) to optimise hypertension control and to compare it with standard clinical care.

Methods Design Multicentric, non-randomised, quasi-experimental controlled intervention study.

Setting 5 PHCTs in the intervention and 13 in the standard care group in the province of Barcelona, Catalonia, Spain.

Participants This is a population-based study in which all patients over 18 years of age with a diagnosis of hypertension before 1 January 2006 were included (n=9877 in the intervention group and n=21 704 in the control group).

Intervention A QI plan that targeted primary care professionals. The plan included training sessions, implementation of recommended clinical practice guidelines for the management of hypertensive patients and audit and feedback to health professionals.

Main outcome measure Prevalence of hypertensive patients with an adequate blood pressure (BP) control.

Results The adjusted difference between intervention and standard care groups in the odds of BP control was 1.3 (95% CI 1.1 to 1.6, p=0.003). Results of the mixed model on repeated measures showed that, on average, an individual in the intervention group had an increase of 92% in the odds of BP control (OR 1.9, 95% CI 1.7 to 2.1).

Conclusions The implementation of a QI plan can improve BP control. This strategy is potentially feasible for up-scaling within the existing PHCTs.

Trial registration ClinicalTrials.gov MS: 1998275938244441.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2011-000507

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    Footnotes

    • ↵* The authors of the INCOTECA research group are listed in appendix 1.

    • To cite: Vallès-Fernández R, Rodriguez-Blanco T, Mengual-Martínez L, et al. Intervention for control of hypertension in Catalonia, Spain (INCOTECA Project): results of a multicentric, non-randomised, quasi-experimental controlled intervention study. BMJ Open 2012;2:e000507. doi:10.1136/bmjopen-2011-000507

    • Contributors RV-F contributed to conception and design of study and analysis and interpretation of data, and drafting and revising of the article and gave final approval. TR-B and MR-M contributed to analysis and interpretation of data and drafting and revising of article and gave final approval. MR-M, LM-M, GP-DL and AF-S contributed to conception and design of study. LM-M, FM-F, SM-M, EB-S, AA-L, JCM-V, MSA-O and IO-M contributed to acquisition of data. JMB-S contributed to drafting and revising of the article.

    • Funding In 2006, the project received the Research Prize in Primary Health Care of the Catalan Health Service Barcelona Region. In 2006, the project was awarded as among the Best Initiatives in Pharmaceutical Attention, published in the Correo Farmacéutico. Esteve Laboratories funded the production of posters and leaflets with the decision-making algorithms. IDIAP Jordi Gol funded the translation of the paper from Spanish into English.

    • Competing interests None.

    • Ethical approval The study protocol received institutional review board approval (IDIAP Jordi Gol Ethical Clinical Committee).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.