Implementation of evidence based cardiovascular risk treatments by general practitioners.
OBJECTIVE
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
Crossen
K
K
Lipid and Diabetes Research Group, Christchurch Hospital.
Scott
R S
RS
McGeoch
G R
GR
George
P M
PM
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control* / Q000628:therapy; D019317:Evidence-Based Medicine; D005194:Family Practice; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008485:Medical Audit; D008487:Medical History Taking; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000960:Hypolipidemic Agents; D001241:Aspirin