Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

Autor: C. Köning, P. Klein-Weigel, S. Wolbergs, I. Flessenkämper, B. Gutsche-Petrak
Rok vydání: 2010
Předmět:
Male
Health Knowledge
Attitudes
Practice

medicine.medical_specialty
Attitude of Health Personnel
Drug Prescriptions
Germany
Diabetes mellitus
Internal medicine
Secondary Prevention
medicine
Humans
Popliteal Artery
Cooperative Behavior
Practice Patterns
Physicians'

Medical prescription
Aged
Retrospective Studies
Aged
80 and over

Patient Care Team
Peripheral Vascular Diseases
Aspirin
Evidence-Based Medicine
business.industry
Cardiovascular Agents
Retrospective cohort study
medicine.disease
Intermittent claudication
Surgery
Femoral Artery
Hospitalization
Treatment Outcome
medicine.anatomical_structure
Health Care Surveys
Concomitant
Practice Guidelines as Topic
Cardiovascular agent
Critical Pathways
Female
Interdisciplinary Communication
Guideline Adherence
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Artery
medicine.drug
Zdroj: Vasa. 39:145-152
ISSN: 1664-2872
0301-1526
DOI: 10.1024/0301-1526/a000020
Popis: Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeon’s awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.
Databáze: OpenAIRE
načítá se...