Cardiovascular disease screening in general practice: General practitioner recording of common risk factors.
The assessment and screening of individual risk factors for cardiovascular disease (CVD) is a critical component of CVD prevention strategies in general practice (GP). This study sought to examine current CVD risk factor recording as recommended by Australian guidelines for the management of absolute cardiovascular disease risk. A retrospective analysis of routine GP data from 149,306 GP patients aged 45years and above in eastern Melbourne was conducted. Data were collected from GP clinics located throughout inner east Melbourne from July 2011 to September 2014 through the Melbourne East Monash General Practice Database. Recording of primary risk factors necessary for CVD screening as recommended by the national guidelines was assessed, and logistic regression with generalised estimating equations was used to estimate associations between patient characteristics and risk factor recording. 137,976 (92.4%) patients were found to have had at least one risk factor recorded, 62,214 (41.7%) had the Framingham risk factors recorded (lipids, blood pressure, smoking status), while only 1957 (1.3%) had all risk factors recorded. Females (Odds Ratio [OR]: 0.72, 95% Confidence Interval [CI]: 0.65, 0.81), and those identified with diabetes (OR: 12.26, 95% CI: 9.58, 15.68) were less and more likely to have documented risk factors, respectively. Given the role of GPs in the prevention and management of CVD, it is important to improve the identification of high risk patients through screening and recording of CVD risk factors. Strategies are therefore needed to encourage ongoing CVD risk factor recording to support preventive care by GPs.
Department of General Practice, School of Primary and Allied Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Victoria 3168, Australia. Electronic address: lyle.turner@monash.edu.
Lyle R
LR
Turner
Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Victoria 3004, Australia; Rheumatology Unit, Alfred Hospital, 55 Commercial Road, Victoria 3004, Australia. Electronic address: flavia.cicuttini@monash.edu.
Flavia
F
Cicuttini
Department of General Practice, School of Primary and Allied Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Victoria 3168, Australia; Melbourne East General Practice Network (trading as Outcome Health), 1/5 Lakeside Drive, Victoria 3151, Australia. Electronic address: chris.pearce@monash.edu.
Christopher
C
Pearce
Department of General Practice, School of Primary and Allied Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Victoria 3168, Australia. Electronic address: danielle.mazza@monash.edu.
Danielle
D
Mazza
D001315:Australia; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors
Cardiovascular disease; Clinical guidelines; Primary care; Screening