全国关于医生意识和遵守心血管疾病预防指南的研究
Lori Mosca1, Allison H Linfante, Emelia J Benjamin
1Columbia University College of Physicians and Surgeons, New York, NY, USA. ljm10@columbia.edu
Circulation
|February 3, 2005
概括
医生经常低估女性心血管疾病 (CVD) 风险,导致预防护理建议中的性别差异. 教育干预对于改善所有患者的心血管疾病预防至关重要.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 健康差异 在健康上的差异
背景情况:
- 关于医生遵守心血管疾病 (CVD) 预防指南的数据有限,根据专业和患者特征,特别是性别.
- 医生意识,采用和国家心血管疾病预防指南的障碍需要进一步调查.
研究的目的:
- 评估医生是否遵守心血管疾病预防指南.
- 根据患者的性别来评估医生在风险分层和指导方针应用中的准确性.
- 确定影响心血管疾病预防建议的因素.
主要方法:
- 在500名医生 (初级保健,产科/妇科,心脏病学) 的网上调查中,评估了指南意识和障碍.
- 一个实验案例研究设计评估了模拟患者的风险评估和指导方针应用.
- 弗雷明汉风险评分被用于评估中等风险患者.
主要成果:
- 中等风险的女性比男性更有可能被医生分配到较低风险的类别 (P<0.0001).
- 风险分配显著预测了改变生活方式和预防药物的建议.
- 预防护理中的性别差异在很大程度上是由感知到的风险解释的,女性接受的阿司匹林较少,更多的体重管理建议.
结论:
- 医生对风险的看法,而不仅仅是计算风险,驱动心血管疾病预防建议.
- 预防心血管疾病的性别差异源于低估了女性的风险.
- 医生教育对于提高心血管疾病预防护理质量和降低患病/死亡率至关重要.
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