Dunkley Alison, Stone Margaret, Sayers Robert, Farooqi Azhar, Khunti Kamlesh
Division of General Practice and Primary Health Care, Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester, UK.
Postgrad Med J. 2007 Sep;83(983):602-5. doi: 10.1136/pgmj.2007.060806.
The National Service Framework for coronary heart disease (CHD) defines standards for the secondary prevention of cardiovascular disease in at risk individuals, including those with peripheral arterial disease (PAD).
To assess current standards of secondary prevention and health monitoring in patients with PAD following a vascular procedure, and additionally compare care in patients with and without diagnosed CHD.
Indicators for this cross sectional survey were identified from national recommendations and evidence. A retrospective review was conducted of general practitioner records, for patients who were treated in hospital for PAD.
Data were collected for 103 patients from 42 practices. Overall, prescribing was well achieved for antiplatelets but poor for statins. Standards of assessment of blood pressure, smoking status, and smoking cessation advice were high. However, approximately only half of the patients received advice about exercise or had their body mass index checked. Furthermore, for all indicators, standards of care for patients who additionally had a diagnosis of CHD were better than for patients without CHD.
The cross sectional survey suggested the treatment received by some patients with established PAD is substandard. There is considerable potential to increase secondary prevention of CHD in patients with PAD disease in primary care.
冠心病国家服务框架定义了对高危个体（包括外周动脉疾病患者）进行心血管疾病二级预防的标准。
评估血管手术后外周动脉疾病患者二级预防和健康监测的当前标准，并比较已确诊冠心病患者和未确诊冠心病患者的治疗情况。
从国家建议和证据中确定本次横断面调查的指标。对因外周动脉疾病住院治疗的患者的全科医生记录进行回顾性分析。
从42家医疗机构收集了103名患者的数据。总体而言，抗血小板药物的处方执行情况良好，但他汀类药物的处方执行情况较差。血压评估、吸烟状况及戒烟建议的标准较高。然而，约只有一半的患者接受了运动建议或进行了体重指数检查。此外，对于所有指标，已确诊冠心病患者的治疗标准优于未确诊冠心病的患者。
横断面调查表明，一些已确诊外周动脉疾病患者接受的治疗未达标准。在初级保健中，提高外周动脉疾病患者冠心病二级预防的潜力巨大。
