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Screening for cardiovascular disease and risk reduction counselling behaviors of general practitioners
A Heywood1, I Ring, R Sanson-Fisher
1Epidemiology and Health Information Branch, Queensland Health, Brisbane.
Insights
Cardiovascular disease risk factors like smoking and obesity are common in general practice. While some screening occurs, preventive care rates are suboptimal, highlighting a need to address barriers in primary care settings.
Area of Science:
- General Practice
- Preventive Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) risk factors are prevalent in the general population.
- General practice plays a crucial role in identifying and managing these risk factors.
- Understanding screening rates and preventive care delivery is essential for public health initiatives.
Purpose of the Study:
- To determine the prevalence of key cardiovascular disease risk factors in general practice patients.
- To assess the rates of screening for these risk factors.
- To evaluate the delivery of preventive care during general practice consultations.
Main Methods:
- Cross-sectional study involving 7,160 adult patients and 230 general practitioners in Queensland.
- Self-administered patient questionnaires collected data on lifestyle risk factors and screening history.
- Physician questionnaires gathered information on clinician awareness and preventive care provision.
Main Results:
- Prevalence: 25% smoking, 2% excessive alcohol intake, 40% overweight (BMI > 24.9).
- Screening: High for blood pressure (>90%), moderate for cholesterol (51%).
- Intervention rates: Highest for blood pressure (47%) and smoking (34%), lowest for cholesterol (6%).
Conclusions:
- Preventive care activities are present in general practice but fall short of ideal performance.
- Significant gaps exist in screening and counseling for major cardiovascular risk factors.
- Barriers to effective preventive care delivery in primary care require identification and resolution.
Background:
This study presents prevalence of risk factors for cardiovascular disease in general practice patients and screening rates for risk factors. Conditions addressed include smoking, weight, alcohol intake, blood pressure, and cholesterol.
Methods:
Adult patients (7,160) attending 230 general practitioners in a metropolitan (Brisbane) and rural (Toowoomba) region in Queensland were recruited to a cross-sectional study. A self-administered patient questionnaire provided self-reported information on lifestyle risk factors and rates of previous screening. A doctor's questionnaire completed at the conclusion of the consultation provided information about physician knowledge of patient risk factors and details of preventive care provided in the consultation.
Results:
Twenty-five percent of patients reported that they smoked, 2% drank beyond defined safe limits, 40% had body mass index > 24.9 (kg/m2). Doctors identified 66% of self-reported smokers, 40% of heavy drinkers, and 59% of overweight patients. Over 90% of patients reported prior blood pressure measurements in agreement with national recommendations; cholesterol screening within the past 5 years was reported by 51% of patients. Screening and/or counselling of patients in the consultation was highest for blood pressure (47%) and smoking (34%) and considerably lower for overweight (22%), alcohol (19%), and cholesterol (6%).
Conclusions:
Although preventive activities are being undertaken in general practice, performance of these activities is less than ideal. The barriers to undertaking these activities need to be addressed for change to occur.
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