Provision of information and advice in cardiovascular care: clinical performance of general practitioners.
The aim of this study was to assess the provision of information and advice by general practitioners (GPs) with respect to patients with hypertension, hypercholesterolaemia, or cardiovascular disease. The study relied on the prospective recording of patient encounters by GPs. Performance indicators were selected from the Dutch national guidelines for general practice. The GPs (n=195) completed 5330 encounter forms. High levels of performance were found with regard to advice on smoking cessation and the provision of information (e.g. information about alarm symptoms or the aim of treatment). Low levels of performance were found with regard to advice on salt consumption, alcohol consumption, weight reduction and physical exercise for patients with hypertension. Discussion of compliance with the therapy in case of hypercholesterolaemia, advice on physical exercise in case of angina pectoris and advice on foot care in case of peripheral arterial disease also showed a substantial gap between recommended and actual care. Performance rates varied considerably across GPs. The patient and GP characteristics examined in this study contributed very little to the clinical performance.
Frijling
Bernard D
BD
Centre for Quality of Care Research, University of Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. b.frihjling@hsv.kun.nl
Lobo
Claudia M
CM
Hulscher
Marlies E J L
ME
van Drenth
Bernard B
BB
Braspenning
Jozé C C
JC
Prins
Ad
A
van der Wouden
Johannes C
JC
Grol
Richard P T M
RP
D002318:Cardiovascular Diseases / Q000628:therapy*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004032:Diet; D005194:Family Practice / Q000592:standards*; D005260:Female; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards*; D011446:Prospective Studies; D012044:Regression Analysis; D016540:Smoking Cessation; D011795:Surveys and Questionnaires