Management of chronic heart failure: perceived needs of general practitioners in light of the new general medical services contract
Autor: | M A Denvir, S P McKee, Stephen J. Leslie, E A Imray |
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Rok vydání: | 2005 |
Předmět: |
medicine.medical_specialty
Evidence-based practice Attitude of Health Personnel Alternative medicine MEDLINE General medical services Nursing Humans Medicine cardiovascular diseases Practice Patterns Physicians' Heart Failure Service (business) Health Services Needs and Demand Clinical Audit business.industry Questionnaire Cardiovascular Agents General Medicine Guideline Community Health Nursing Scotland Family medicine Chronic Disease Practice Guidelines as Topic Cardiovascular agent cardiovascular system Family Practice business |
Zdroj: | Postgraduate Medical Journal. 81:321-326 |
ISSN: | 1469-0756 0032-5473 |
DOI: | 10.1136/pgmj.2004.022947 |
Popis: | Background Despite the existence of several chronic heart failure (CHF) guidelines the treatment of patients with CHF is suboptimal. The new general medical services (GMS) contract in primary care has only three specific performance indicators for patients with left ventricular dysfunction. The aim of this current questionnaire survey was to assess the views of general practitioners (GPs) on CHF treatments and services in light of the new GMS contract. Methods and Results All local GPs (717) were sent a questionnaire. Fifty three per cent were returned. Forty five per cent of GPs had access to a community CHF nurse. Having read a national guideline (SIGN) and having the support of a CHF nurse did not seem to affect the knowledge of GPs in terms of perceived benefits of drug treatments. GPs with access to a specialist CHF nurse service attached more importance to it than those with no specialist nurse (p = 0.003). Conclusions Most GPs were aware of the existence of a national guideline but many had not read it. There was little or no difference in the knowledge level for various evidence based treatments between GPs who had or had not read the guideline suggesting that reading guidelines may not be a key factor in determining knowledge. Support for a specialist CHF nurse was higher among GPs who already had this service, suggesting that this service is valued. The new GMS contract may improve identification and diagnosis of patients with CHF but there is a danger that it may fall short of ensuring optimal treatment for patients with CHF. |
Databáze: | OpenAIRE |
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