Combined training of GPs and practice-assistants on peripheral arterial disease: positive effects after six months.
OBJECTIVE
To improve the use of the ankle-brachial index (ABI) measurement, and management of patients with peripheral arterial disease (PAD) a combined training, targeting GPs and practice assistants (PAs) was developed. To measure the effect of the combined training on the management of patients with PAD, a cross-sectional study was performed.


METHODS
Fifty consecutive patients referred by GPs to a vascular surgery out-patient clinic were analysed. Six months after the training an additional fifty patients were included. In all patients the ABI measurement, risk factor management, and treatment as performed by the GP, prior to referral, were analysed.


RESULTS
The measurement of the ABI significantly increased from 10% before the training to 53% after the training (GPs with training: 83%, GPs without training: 35%; P: 0.001). The referral of patients with actual PAD significantly increased from 32% before the training to 70% after the training (GPs with training: 83%, GPs without training: 59%; P: 0.05). The presence and treatment of risk factors did not differ between the groups.


CONCLUSIONS
Within the limitations of a before and after study the combined training of GPs and PAs appears to be an effective method to increase ABI measurements and significantly improve adequate diagnostics.
Atrium Medical Centre, Department of Surgery, Division of Vascular Surgery, Heerlen, The Netherlands.
Edith M
EM
Willigendael
Joep A W
JA
Teijink
Marie-Louise
ML
Bartelink
Machteld
M
Langenberg
Rob J Th J
RJ
Welten
Harry R
HR
Büller
Martin H
MH
Prins
D000368:Aged; D000842:Ankle / Q000098:blood supply; D001916:Brachial Artery / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004496:Education, Continuing; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D010823:Physician Assistants; D011787:Quality of Health Care