title: Motives for requesting an electrocardiogram in primary health care.
abstract: The management of requests for diagnostic exams presents its own inherent characteristics in primary health care and reflects the specific nature of the physician-patient relationship. The scope of the study was to identify the reasons for requesting an electrocardiogram (ECG) in primary health care. A cross-sectional study was conducted in an urban region in Portugal, establishing the motives to ask for an ECG consecutively over two years, starting on 01/03/2007 using data retrieved from structured forms filled out by the physician at the moment of requesting the exam. A total of 870 ECGs of 817 patients were included. Symptoms manifested during the patient visit justified 48.5% of the ECGs, and follow-up of cardiovascular risk factors motivated 25.2%. A global health examination accounted for 22.8% of the requests. Multivariate analysis showed that the presence of symptoms (p < 0.001), presence of any cardiovascular risk factor (p = 0.002), hypertension (p < 0.001), diabetes (p = 0.002), and urgency (p < 0.001) were the main factors associated with the requests. The requests for electrocardiograms are predominantly for clinical reasons as a result of patients symptoms. The integration of expectations and beliefs of the patients is present in the decision-making process.
authors.affiliation: Departamento de Ciências Sociais e Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, psantosdr@med.up.pt.
authors.forename: Paulo
authors.initials: P
authors.lastname: Santos
authors.affiliation: Departamento de Ciências Sociais e Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, psantosdr@med.up.pt.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martins
authors.affiliation: Departamento de Ciências Sociais e Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, psantosdr@med.up.pt.
authors.forename: Luísa
authors.initials: L
authors.lastname: Sá
authors.affiliation: Departamento de Ciências Sociais e Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, psantosdr@med.up.pt.
authors.forename: Alberto
authors.initials: A
authors.lastname: Hespanhol
authors.affiliation: Departamento de Ciências Sociais e Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, psantosdr@med.up.pt.
authors.forename: Luciana
authors.initials: L
authors.lastname: Couto
mesh_terms: D002318:Cardiovascular Diseases; D000066491:Clinical Decision-Making; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010817:Physician-Patient Relations; D011320:Primary Health Care