Knowledge and implementation of cardiovascular risk clinical practice guidelines by general practitioners and specialists

被引:27
|
作者
Gonzalez-Juanatey, Jose R.
Alegria-Ezquerra, Eduardo
Aznar-Costa, Joaquin
Bertomeu-Martinez, Vicente
Franch-Nadal, Josep
Palma-Gamiz, Jose L.
机构
[1] Univ Navarra Clin, Dept Cardiol & Cirugia Cardiovasc, Pamplona 31008, Spain
[2] Hosp Nuestra Senora Gracia, Serv Cardiol, Zaragoza, Spain
[3] Hosp Univ San Juan, Serv Cardiol, Alicante, Spain
[4] Ctr Atencion Primaria Raval Sud, Barcelona, Spain
[5] Hosp Ramon & Cajal, Serv Cardiol, E-28034 Madrid, Spain
[6] Hosp Clin Univ Santiago, Serv Cardiol, Santiago De Compostela, A Coruna, Spain
来源
REVISTA ESPANOLA DE CARDIOLOGIA | 2006年 / 59卷 / 08期
关键词
clinical practice guidelines; diabetes mellitus; coronary disease; cardiovascular prevention;
D O I
10.1157/13091884
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction and objectives. Patients at a high risk of cardiovascular disease rarely achieve the preventive targets stipulated by the clinical practice guidelines published by professional bodies. The aims of the ACORISC registry were to determine the level of compliance with guidelines on prevention by general practitioners and specialists and to assess the findings in terms of risk factors. Methods. The study included 5849 consecutive patients (mean age 65 years) with type 2 diabetes or chronic ischemic heart disease who were seen as outpatients. In addition, 384 participating physicians were questioned on their knowledge and use of practice guidelines. Results. Overall, 91% of patients also had hypertension. Physicians tended to have better knowledge of and to implement guidelines published by the closest related professional bodies. Some 14% of treatment provided was inappropriate, half of which involved oral antidiabetics. Conversely, 48% of patients for whom guidelines recommended an angiotensin inhibitor did not receive one. The target figures for blood pressure, body mass index, and cholesterol were achieved in only 13%, 21% and 39% of patients, respectively. Conclusions. Overall, 75% of risk factors in patients with diabetes or chronic ischemic heart disease were not appropriately treated by general practitioners or specialists in accordance with current clinical practice guidelines. The inappropriate use of oral antidiabetics was particularly common.
引用
收藏
页码:801 / 806
页数:6
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