Related Experiment Videos
Implementation of evidence based cardiovascular risk treatments by general practitioners
K Crossen1, R S Scott, G R McGeoch
1Lipid and Diabetes Research Group, Christchurch Hospital.
Insights
General practitioners (GPs) widely use cardioprotective drugs for coronary heart disease (CHD) patients but often neglect lifestyle advice. Cholesterol targets are frequently missed, indicating a need for improved monitoring and recording of cardiovascular risk reduction strategies.
Area of Science:
- Cardiology
- General Practice
- Public Health
Background:
- Coronary heart disease (CHD) management requires evidence-based cardiovascular risk reduction strategies.
- General practitioners (GPs) play a crucial role in implementing these strategies.
Purpose of the Study:
- To review the implementation of evidence-based cardiovascular risk reduction strategies by GPs in patients with CHD.
- To assess the recording and achievement of National Heart Foundation (NHF) guidelines for lipid parameters.
Main Methods:
- An audit of patient records from randomly selected GPs was conducted.
- Data on lifestyle advice, medication use, and lipid levels were extracted and analyzed.
Main Results:
- Lifestyle measure details were rarely documented, except for smoking cessation advice.
- Cardioprotective medications like aspirin and beta-blockers were widely prescribed.
- While 71% of eligible patients received lipid-modifying drugs, only 37% achieved target total cholesterol and 60% achieved target TC/HDL ratios.
Conclusions:
- Recording of lifestyle interventions for CHD patients is a low priority for GPs.
- Cardioprotective treatments are commonly used, but recommended lipid targets are not consistently met.
- Improved monitoring of lipid parameters could enhance cardiovascular risk reduction in CHD patients.
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