title: The quality of cardiovascular disease prevention in rural primary care.
abstract: OBJECTIVE
  To measure the differences in the recording of risk factors and lifestyle advice between those at high risk of cardiovascular disease and those diagnosed with cardiovascular disease, and to identify the practice characteristics associated with such recording in rural primary care.
  
  
  METHODS
  A cross-sectional observation study of 14 general practices. Medical records were audited to measure recording of risk factors and lifestyle advice for those at high risk of and those diagnosed with cardiovascular disease. Practice characteristics were collected, with logistic regression used to test for an association with the recording of risk factors.
  
  
  METHODS
  General practices in rural Australia.
  
  
  METHODS
  Each practice was asked to identify 20 patients; 10 at high risk and 10 diagnosed with cardiovascular disease.
  
  
  METHODS
  The recording of risk factors and lifestyle advice in patient records and practice characteristics.
  
  
  RESULTS
  282 records were audited with 142 being high risk and 140 diagnosed with cardiovascular disease.Measures recorded significantly less in the high-risk group were: blood pressure (94% versus 99%; P = 0.019); physical activity (24% versus 56%; P = 0.000); dietary advice (32% versus 51%; P = 0.001); and physical activity advice (34% versus 56%; P = 0.000). Recording of risk factors was positively associated with practice involvement in quality improvement (P < 0.001), continuing education (P < 0.001), and greater percentage of general practitioners (P < 0.05) and practice nurses (P < 0.001).
  
  
  CONCLUSIONS
  There is substantial room for enhanced cardiovascular disease prevention through rural primary care in Australia, particularly for high-risk patients. This study has demonstrated an association between practice factors (including targeted education, quality improvement activities and appropriate workforce) and improved preventive activities.
authors.affiliation: School of Rural Health, Monash University, Bendigo, Victoria, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Allenby
authors.affiliation: School of Rural Health, Monash University, Bendigo, Victoria, Australia.
authors.forename: Leigh
authors.initials: L
authors.lastname: Kinsman
authors.affiliation: School of Rural Health, Monash University, Bendigo, Victoria, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Tham
authors.affiliation: School of Rural Health, Monash University, Bendigo, Victoria, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Symons
authors.affiliation: Psychology Department, Macquarie University, Sydney, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Jones
authors.affiliation: Institute of Population Health, Centre for Primary Care, University of Manchester, Manchester, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Campbell
mesh_terms: D000368:Aged; D001315:Australia; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D054626:Consumer Health Information; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011320:Primary Health Care; D012424:Rural Population; D011795:Surveys and Questionnaires
keywords: CVD research; cardiovascular risk factor; health service model; model of care; primary health care