BackgroundHealth-related quality of life (HRQoL) is measuring a patient’s experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.MethodsA cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient’s HRQoL as an independent variable.Results871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).ConclusionThis study has been performed on a specific group of patients, not being “really sick”, but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.
The level of achievement of learning objectives increased with the experiences of the teachers. We improved the attitude of medical students toward general practice and general practitioners. We have not been successful in influencing career choice of students, which is an objective that is probably outside our reach.
The determinants that influence statin prescribing behavior among GPs in our study covered an array of explanatory items consistent with proposals in the literature but factors differ to some extent from proposed theoretical models. The explanatory model explained a high proportion of the variation in deciding on a particular statin. Efficacy and safety remain important factors in selection of an appropriate drug but are far from being the most or only important factors.
The impact of hypertension guidelines on patients' management in everyday primary care appears marginal. More emphasis should be placed on the efficient implementation of the guidelines.
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