Secondary prevention in coronary heart disease: baseline survey of provision in general practice

Campbell, Neil; Thain, J; Deans, Heather; Ritchie, Lewis D; Rawles, John

doi:10.1136/bmj.316.7142.1430

Cited by 196 publications

(147 citation statements)

References 19 publications

(25 reference statements)

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“…The same was applied to practice characteristics that had a significant relation either with the 1 The Minimal Intervention Strategy is a smoking cessation package shown to be feasible and effective. 2 Checked by observation whether the leaflets were within reach during the consultation. 3 Adequate ancillary staff present =0.8 full-time equivalent practice assistance per 2500 patients (norm).…”

Section: Discussionmentioning

confidence: 99%

“…1 100% computerized =practices that do not use any written medical records: all patient data were entered into the computer. 2 Systematic entries were at least necessary for hypertension, diabetes mellitus, individual and family cardiovascular history. 3 The risk factors that had to be recorded separately were hypertension, smoking and individual cardiovascular history.…”

Section: Discussionmentioning

confidence: 99%

“…Delivery of preventive services can reduce cardiovascular morbidity and mortality. Despite a high level of support for the importance of prevention, physician delivery of preventive services falls far below recommended levels (2). Barriers to prevention can be divided into barriers related to the physician, to the patient and to the organisational setting within the practice (3,4).…”

mentioning

confidence: 99%

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Organisational determinants of cardiovascular prevention in general practice

Lobo¹,

Frijling²,

Hulscher³

et al. 2003

Scandinavian Journal of Primary Health Care

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Organisational determinants of cardiovascular prevention in general practice

Lobo¹,

Frijling²,

Hulscher³

et al. 2003

Scandinavian Journal of Primary Health Care

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“…Unfortunately, in spite of the ample evidence for recommending aspirin usage for secondary prevention of cardiovascular disease 6 , recent studies in USA and Europe revealed significant gaps in secondary prevention 7,8 with suboptimal prescription rates in patients who already have coronary heart disease [9][10][11][12] .…”

mentioning

confidence: 99%

Knowledge, attitudes and current practice of Jordanian family physicians about prescribing aspirin in primary and secondary prevention of vascular diseases: a self-reported survey

Omari

Khader

Al‐Azzam

et al. 2010

European Journal of Cardiovascular Nursing

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Background: Long-term aspirin therapy is crucial for patients with increased risk of occlusive vascular diseases. However, inconsistencies in the methods for risk assessment and the perception among health care providers are major contributing factors for challenges in risk assessment. Methods: A questionnaire was distributed to a total of 124 family physicians working at two university teaching centers and Ministry of Health primary health care centers in Jordan. Results: A majority of the physicians reported prescribing aspirin for patients if they have peripheral vascular disease (93%), post-coronary artery bypass graft (92%), stroke (90%), or stable angina (95%). A smaller percentage of physicians reported that they prescribe aspirin if patients have atrial fibrillation (81%) or acute myocardial infarction (85%). The percentage of physicians who prescribe aspirin markedly declined when patients have potential bleeding disorder (52%) or asthma (52%). For patients without cardiovascular diseases but with one or more risk factors, the prophylactic use of aspirin was reported by 85% to 95% of family physicians. Conclusions: The presence of co-morbidity along with vascular diseases tended to hinder physicians from prescribing aspirin even when it is indicated. A majority of family physicians recommends the use of aspirin in primary prevention in spite of its questionable or even negative benefits. Furthermore, self-reported aspirin prescribing rates among physicians in Jordan are higher than those reported by physicians in the U.S. and Europe. Therefore, we believe that proper dissemination of updated evidence-based treatment guidelines is required to ensure appropriate and efficient preventive services for cardiovascular diseases.

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“…Several papers have reported concern about the small use of these drugs and the resulting damage suffered by patients who do not receive this treatment [9][10][11] , even in the USA and in Europe. In Great Britain, a recent study showed that only in 17% of patients with indication of secondary prevention presented lipid concentrations, according to the official guidelines 11 . In our environment, the situation is more critical yet, because the socioeconomic situation in Brazil prevents the correct use of statins, even when the cardiologists are absolutely sure about its indication.…”

mentioning

confidence: 99%