title: GP detection of health risk factors among general practice patients at risk of primary and secondary stroke.
abstract: BACKGROUND
  People with a history of stroke or heart disease are at increased risk of future stroke; therefore, identification of risk factors by GPs is critical.
  
  
  OBJECTIVE
  To compare the following among general practice patients with and without a history of stroke or heart disease: (i) self-reported prevalence rates of lifestyle risk factors; (ii) accuracy of GP detection of patient-reported risk factors and (iii) average proportion of patient-reported risk factors detected by GPs.
  
  
  METHODS
  Consecutive patients attending a participating general practice clinic were invited to participate in a cross-sectional touchscreen survey assessing lifestyle risk factors in 2010-11. The GP of each consenting patient completed a corresponding survey assessing the patient's risk factors. Demographic characteristics of patients and GPs were obtained.
  
  
  RESULTS
  Data from 51 GPs and 564 patients were analysed. Patients without a history of stroke or heart disease reported significantly higher rates of smoking (12%) and risky alcohol consumption (56%) than patients with a history of stroke or heart disease (6% and 36%, respectively). Low sensitivity of GP detection of risk factors was found for all risk factors for all patients. Patients with a history of stroke or heart disease have a significantly higher mean proportion of risk factors detected by their GP compared to patients without a history of stroke or heart disease (P = 0.00).
  
  
  CONCLUSIONS
  Given low sensitivity and specificity of GP detection of risk factors among patients, alternate methods of identification are needed. Research is required to determine strategies to facilitate secondary care of patients with a history of stroke or heart disease by GPs.
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales 2308, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305 and alice.grady@newcastle.edu.au.
authors.forename: Alice
authors.initials: A
authors.lastname: Grady
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales 2308, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305 and.
authors.forename: Mariko
authors.initials: M
authors.lastname: Carey
authors.affiliation: Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305 and.
authors.forename: Christopher
authors.initials: C
authors.lastname: Oldmeadow
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales 2308, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305 and.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bryant
authors.affiliation: Department of General Practice, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria 3168, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales 2308, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305 and.
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D002983:Clinical Competence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D015438:Health Behavior; D006306:Health Surveys; D006331:Heart Diseases / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009517:New South Wales; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D055502:Secondary Prevention / Q000379:methods*; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014739:Victoria; D055815:Young Adult
keywords: At-risk groups; prevention; primary care; screening; stroke.