Utilización de la ecuación de Framingham-REGICOR en un centro de atención primaria. Impacto sobre la prevención primaria de las enfermedades cardiovasculares

Abstract

Objectives. To evaluate the adequacy of cardiovascular primary prevention by calculating cardiovascular risk (CVR) with 2 different equations and to evaluate the economic impact of the resulting drug expenditure. Design. By means of a transversal study of all the new cases of lipaemia diagnosed, patients were classified in 2 CVR categories (≥20% and <20%).The Framingham-Wilson (FW) and Framingham-REGICOR (FR) equations were used to analyse the difference between observed treatments (really prescribed) and expected treatments. Costs were compared. Setting. Barceloneta PCC, Barcelona, Spain. Patients. Ninety-two cases of lipaemia (2002 and 2003) that met the following inclusion criteria: no coronary history, no taking of lipid-lowering drugs, and age between 35 and 74. There were 10 losses in the 92 individuals through lack of a variable for calculating CVR. Results. According to the clinical criterion, 22 of the 82 patients were treated with medication (26.82%). The expected proportion of patients treated when the FW equation was used was 24.39% (20/82); and was 0% (0/82) with the FR equation. On applying the FW equation, it was seen that 12 of 22 patients treated and 10 of 60 patients not treated did not receive the correct drug treatment. If the mean cost per patient treated and per year at the PCC is applied to the new cases, there is a 9.09% reduction (€479.2) for the FW equation and 100% (€5271.2) for the FR equation. Conclusions. The use of one or other algorithm for calculating CVR entails pertinent differences in clinical practice and expenditure. All patients in primary prevention must receive non-pharmacological treatment.