Obstacles to cardiovascular prevention in general practice

Abstract

This survey showed that these GPs underestimated the CV burden, lacked a systematic approach to global risk assessment and used to focus on cholesterol treatment rather than on global CV risk management.

Barriers to apply cardiovascular prediction rules in primary care: a postal survey

“…Scepticism in cardiovascular prediction rules seems to be considerable among our respondents. The rate of "rarely"- or "never"-users was 74%, which is beyond the results of about 50% reported in recent surveys [4,5] but fits well with the results of a postal survey among Norwegian general practitioners [10]. In addition, the application of more than five prediction rules with partly diverse outcomes may reflect a general uncertainty even among "often-users" which prediction rule to apply for daily practice.…”

“…Family doctors probably misinterpret comprehensive knowledge about their patients as an ability to correctly estimate their global cardiovascular risk. In addition, among some doctors a "treatment reflex" with prescription of lipid-lowering drugs for persons with isolated hyperlipidemia may exist (irrespective of a possibly low global risk like in persons without hypertension, without smoking, and of young age) [4]. The data from our survey support this hypothesis.…”

“…Studies have shown, however, that general physicians rarely apply cardiovascular prediction rules [4,5]. Little is known about barriers for application in daily practice [6,7].…”

Preventing coronary heart disease risk of slum dwelling residents in India

“…Though, there is no published study in India, studies in developed countries have shown suboptimal use of risk prediction charts to estimate an individual's 5-10 years ACR score in primary practice (varying from 17 to 47%). [262728] One qualitative study in Australia demonstrated that general practitioners (GPs) do not routinely perform absolute CHD risk assessments. [29] Furthermore, some studies confirm that when doctors do use CHD risk assessment tools, they are not always used correctly.…”

Missed opportunities in prevention of cardiovascular disease in primary care: a cross-sectional study

“…16,17 Thus, it is possible that those included in the primary prevention population may have been sicker than those in the general population because risk factors are usually only measured where there is a clinical suspicion of risk. Despite this, the included population was considered comparable with the national population aged between 35 28 These data are advantageous over those from the Health Survey for England 27 because the entire population from the study area was sampled, therefore removing any bias from differential response rates.…”