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新西兰常规初级保健实践中基于网络的心血管疾病风险评估:首批18000名患者(PREDICT CVD-1)。

Web-based assessment of cardiovascular disease risk in routine primary care practice in New Zealand: the first 18,000 patients (PREDICT CVD-1).

作者信息

Bannink Lot, Wells Susan, Broad Joanna, Riddell Tania, Jackson Rod

机构信息

Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland.

出版信息

N Z Med J. 2006 Nov 17;119(1245):U2313.

Abstract

AIM

To describe the cardiovascular disease (CVD) risk factor status of approximately 18,000 patients profiled in routine primary care practice by PREDICT-CVD, a web-based clinical decision support program for assessing and managing CVD risk.

METHODS

Between 2002 and 2005, 31,241 CVD risk assessments of 18,260 patients were undertaken in ProCare, a large primary care organisation in Auckland.

RESULTS

Baseline risk assessments were completed for 10,374 (57%) men and 7886 (43%) women. The mean age was 56 years (range 17 to 94 years), Of those assessed, 11% were of Pacific and 7% of Maori ethnicity. Risk assessment was more likely in men under the age of 65 years. In the over 65 year age group, women were more likely to be risk assessed. The overall prevalence of diabetes and smoking in this cohort was 14% and 13% respectively. A history of a previous CVD event increased with age in both men and women. Above the age of 75 years, 36% reported a previous cardiovascular event, most commonly ischaemic heart disease. The patients assessed represented 6% of men and 4% of women in the enrolled ProCare population over 35 years of age.

CONCLUSIONS

General practitioners and practice nurses using PREDICT-CVD targeted patients according to national guideline age and gender recommendations. PREDICT-CVD is a practical and effective tool for systematically generating standardised patient CVD risk factor profiles during routine primary care practice. When implemented widely, PREDICT will enable primary care organisations to monitor the CVD risk burden and management in their practice populations using a nationally standardised evidence-based approach.

摘要

目的

描述通过PREDICT-CVD(一个用于评估和管理心血管疾病风险的基于网络的临床决策支持程序)在常规初级保健实践中进行风险评估的约18000名患者的心血管疾病(CVD)风险因素状况。

方法

2002年至2005年期间,在奥克兰的一个大型初级保健机构ProCare中,对18260名患者进行了31241次心血管疾病风险评估。

结果

完成了10374名(57%)男性和7886名(43%)女性的基线风险评估。平均年龄为56岁(范围17至94岁)。在接受评估的人群中,11%为太平洋岛民,7%为毛利族。65岁以下男性进行风险评估的可能性更大。在65岁以上年龄组中,女性进行风险评估的可能性更大。该队列中糖尿病和吸烟的总体患病率分别为14%和13%。既往心血管疾病事件的病史在男性和女性中均随年龄增加。75岁以上人群中,36%报告有既往心血管事件,最常见的是缺血性心脏病。接受评估的患者占ProCare登记的35岁以上人群中男性的6%和女性的4%。

结论

使用PREDICT-CVD的全科医生和执业护士根据国家指南的年龄和性别建议对患者进行了针对性评估。PREDICT-CVD是在常规初级保健实践中系统生成标准化患者心血管疾病风险因素概况的实用有效工具。广泛实施后,PREDICT将使初级保健机构能够使用全国标准化的循证方法监测其实践人群中的心血管疾病风险负担和管理情况。

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