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GP's adherence to guidelines for cardiovascular disease among elderly: a quality development study
Sara Modig1, Peter Höglund, Margareta Troein
1Division of Family Medicine, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, 205 02 Malmö, Sweden. sara.modig@med.lu.se
Thescientificworldjournal
|May 31, 2012
Summary
General practitioners showed low adherence to cardiovascular disease guidelines in the elderly. Local education improved adherence, suggesting it is a valuable tool for enhancing geriatric cardiovascular care.
Area of Science:
- Geriatric Medicine
- Cardiovascular Medicine
- Primary Health Care
Background:
- Evidence-based guidelines are crucial for optimal elderly care.
- Older adults are frequently undertreated with recommended medications.
- Cardiovascular diseases remain a significant health concern in the elderly population.
Purpose of the Study:
- To assess general practitioner adherence to cardiovascular disease guidelines in elderly patients.
- To evaluate the effectiveness of local educational interventions in improving guideline adherence.
Main Methods:
- Retrospective analysis of medical records for patients aged 65+ with cardiovascular conditions (hypertension, ischemic heart disease, heart failure, chronic atrial fibrillation, prior stroke).
- Data collected from a Swedish primary health care center in 2006, with follow-up measurements in 2008 after educational intervention.
- Intervention included physician feedback and discussion of regional guidelines.
Main Results:
- Initial adherence to guidelines was low across various cardiovascular conditions.
- Only one-third of hypertension patients achieved target blood pressure; stroke patients showed better adherence.
- While improved compared to other European countries, only 60% of heart failure patients received ACE inhibitors.
- Warfarin use in chronic atrial fibrillation patients (65+) was suboptimal, with only half treated despite high stroke risk (CHADS(2) score).
Conclusions:
- Guideline adherence for cardiovascular disease in the elderly is suboptimal.
- Local educational initiatives demonstrated a positive impact on improving adherence.
- Targeted education and feedback are recommended to enhance the quality of cardiovascular care for older adults.
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