Madsbad Sten, Larsen Mogens Lytken, Adeler Haagen F, Kryhlmand Marianne, Westergaard Mogens
H:S Hvidovre Hospital, Endokrinologisk Afdeling, Hvidovre.
Ugeskr Laeger. 2006 Apr 24;168(17):1640-5.
The objectives of this study were, first, to describe the status of implementation of clinical guidelines for prevention of ischaemic heart disease in subjects with arterial hypertension, dyslipidemia and type 2 diabetes, but without known cardiovascular disease, and, second, to describe the changes in treatment following journal audit and education of GPs.
230 general practitioners (GPs) were invited to include 20 consecutive at-risk patients. One year after the first data collection of 3,555 patients by 182 GPs, a new set of 3,023 patients was collected by 170 GPs from a new patient population. In the period between the two surveys, the GPs were educated through workshops and an international meeting focusing on cardiovascular risk factor treatment.
The quality of the care being delivered was suboptimal. Approximately 15-40% of the patients had obtained the treatment goals for hypertension, dyslipidemia and type 2 diabetes. Some improvement was demonstrated following education and journal audit, but a gap still exists between the recommended treatment and the treatment patients actually receive.
There is a need for improvement in the implementation of clinical guidelines focusing on diabetes and cardiovascular disease.
本研究的目的，其一，描述针对患有动脉高血压、血脂异常和2型糖尿病但无已知心血管疾病的患者预防缺血性心脏病临床指南的实施状况；其二，描述在对全科医生进行期刊审核及教育之后治疗方面的变化。
邀请了230名全科医生（GP），要求他们纳入连续20名有风险的患者。在182名全科医生首次收集3555名患者的数据一年后，170名全科医生从新的患者群体中收集了一组新的3023名患者的数据。在两次调查期间，通过研讨会和一次聚焦心血管危险因素治疗的国际会议对全科医生进行了教育。
所提供的护理质量欠佳。约15% - 40%的患者达到了高血压、血脂异常和2型糖尿病的治疗目标。在接受教育和期刊审核之后有了一些改善，但推荐治疗与患者实际接受的治疗之间仍存在差距。
有必要改进针对糖尿病和心血管疾病的临床指南的实施情况。
