Implementation of evidence based cardiovascular risk treatments by general practitioners.
| Autor: | Crossen K; Lipid and Diabetes Research Group, Christchurch Hospital., Scott RS, McGeoch GR, George PM |
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| Jazyk: | angličtina |
| Zdroj: | The New Zealand medical journal [N Z Med J] 2001 Jun 08; Vol. 114 (1133), pp. 260-2. |
| Abstrakt: | Aim: To review general practitioner (GP) implementation of evidence based cardiovascular risk reducing strategies in subjects with coronary heart disease (CHD). Methods: Audit of patient records of randomly selected GPs. Results: There were 326 subjects with CHD under the care of 21 doctors. Except for smoking, details of lifestyle measures were rarely found in the notes. Advice on diet and exercise was mentioned in 51% and 23.3% of records respectively. Aspirin and beta-blockers were widely used. Of patients with drug untreated values of total cholesterol (TC) and/or TC/HDL exceeding National Heart Foundation (NHF) guidelines, 71% were prescribed lipid-modifying drugs. NHF targets for TC (< or = 5.0 mmol/l) were achieved by 37% and for TC/HDL (< or = 4.5) by 60%. TC remained above 5.5 mmol/L in 120 cases. Lipid results from tests within the last 12 months were found in 60% of cases. Conclusions: Recording of lifestyle treatments in subjects with CHD appears to be assigned low priority. Cardioprotective treatments were widely used. Cholesterol levels were recorded frequently and of those with values exceeding NHF guidelines, nearly 3/4 were on medication. Recommended targets for lipid parameters were being achieved by <50% of patients. More frequent monitoring could improve this outcome |
| Databáze: | MEDLINE |
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