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 surgeons awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs. |
Databáze: | OpenAIRE |
Externí odkaz: |
načítá se...