Provision of preventive care activities for primary cardiovascular disease: results from a general practitioner clinical audit.

Author: 
Nighat Faruqi, Nigel Stocks, Oshana Hermiz, Kathryn Powell, Catherine Spooner, Mark Harris
Publication type: 
Conference presentation
Program: 
Stream 2 Disadvantaged populations
Year: 
2015
2015 PHC Research Conference, Adelaide, 29-31 July 2015

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Aims and rationale

Our aim was to evaluate general practitioner (GP) provision of preventive care activities related to modifiable risk factors for cardiovascular disease.

Methods

E-records of participating GPs from 20 practices were audited for patients aged 40-70 years. GPs were given audit reports comparing their practice against audit findings from a previous study conducted in 2013. GPs were asked to reflect on results and identify barriers/facilitators to practice improvement.

Findings

Thirty eight GPs participated. Records of 18,743 patients (47% male) were audited. Overall, risk factor assessment was low and varied greatly between practices. Smoking was assessed in 49% (30-96%) and alcohol in 12% (2-69%) of patients. Body mass index (BMI) and waist circumference were assessed in 34% (6-93%) and 6% (0-38%), respectively. In patients without hypertension, blood pressure (BP) was recorded for 63% (29-91%) and with hypertension for 83% (0-96%). Lipid profile was checked in ~40% (9-79%). Compared to previous data, assessment was less frequent for smoking, alcohol, lipids and BP in patients with hypertension, whereas waist circumference measurement remained unchanged and BMI and BP in normotensives were more frequently recorded. GPs found their preventive care assessment levels lower than expected. They identified time as a barrier to practice improvement and involving nurses a facilitator to overcome it. 

Relevance

Interventions to improve risk factor assessment need to address patient factors e.g. their infrequent practice visits, system factors responsible for information capture and barriers such as GP time. Practice nurse role in assisting GPs with regular assessment should be promoted.