Coronary heart disease prevention: the role of the general practitioner

The objectives of the study were to identify the level of general practitioner (GP) involvement in activities aimed at coronary heart disease prevention and to explain variations in involvement. These questions were explored through a postal survey of a random sample (n = 1696) of GPs in England of whom 64% completed questionnaires. Ninety-four per cent of GPs reported that they were involved in risk factor assessment in the consultation although these assessments most commonly involved blood pressure testing and identification of smoking. Ninety-one per cent of practices were reported by the GP to have a lifestyle risk assessment clinic where there was more evidence of systematic risk assessment. These clinics were usually run by a practice nurse as were lifestyle risk factor management clinics although GPs were more involved in hypertension and cholesterol clinics. Positive attitudes to prevention and training in health promotion were associated with higher GP involvement, and higher practice involvement was associated primarily with the number of practice nurses employed. The implication of these findings are discussed.