Service d'Epidemiologie et Santé Publique, Institut Pasteur de Lille, INSERM U744, Univ Lille Nord de France, 1 rue du Pr Calmette, Lille Cedex, France.
Eur J Prev Cardiol. 2012 Jun;19(3):541-50. doi: 10.1177/1741826711407705. Epub 2011 Apr 18.
To assess the practices of physicians in 12 European countries in the primary prevention of cardiovascular disease (CVD).
In 2009, 806 physicians from 12 European countries answered a questionnaire, delivered electronically or by post, regarding their assessment of patients with cardiovascular risk factors, and their use of risk calculation tools and clinical practice guidelines (ClinicalTrials.gov number: NCT00882336). Approximately 60 physicians per country were selected (participation rate varied between 3.1% in Sweden and 22.8% in Turkey).
Among participating physicians, 85.2% reported using at least one clinical guideline for CVD prevention. The most popular were the ESC guidelines (55.1%). Reasons for not using guidelines included: the wide choice available (47.1%), time constraints (33.3%), lack of awareness of guidelines (27.5%), and perception that guidelines are unrealistic (23.5%). Among all physicians, 68.5% reported using global risk calculation tools. Written charts were the preferred method (69.4%) and the most commonly used was the SCORE equation (35.4%). Reasons for not using equations included time constraints (59.8%), not being convinced of their usefulness (21.7%) and lack of awareness (19.7%). Most physicians (70.8%) believed that global risk-equations have limitations; 89.8% that equations overlook important risk factors, and 66.5% that they could not be used in elderly patients. Only 46.4% of physicians stated that their local healthcare framework was sufficient for primary prevention of CVD, while 67.2% stated that it was sufficient for secondary prevention of CVD.
A high proportion of physicians reported using clinical guidelines for primary CVD prevention. However, time constraints, lack of perceived usefulness and inadequate knowledge were common reasons for not using CVD prevention guidelines or global CVD risk assessment tools.
评估 12 个欧洲国家的医生在心血管疾病（CVD）一级预防中的实践情况。
2009 年，来自 12 个欧洲国家的 806 名医生通过电子或邮寄方式回答了一份关于其对心血管危险因素患者评估以及使用风险计算工具和临床实践指南的调查问卷（ClinicalTrials.gov 编号：NCT00882336）。每个国家约选择 60 名医生（参与率在瑞典为 3.1%，土耳其为 22.8%之间变化）。
在参与的医生中，85.2%报告至少使用了一种 CVD 预防临床指南。最受欢迎的是 ESC 指南（55.1%）。不使用指南的原因包括：可供选择的范围广泛（47.1%）、时间限制（33.3%）、对指南缺乏认识（27.5%）和认为指南不切实际（23.5%）。在所有医生中，68.5%报告使用全球风险计算工具。书面图表是首选方法（69.4%），最常用的是 SCORE 方程（35.4%）。不使用方程的原因包括时间限制（59.8%）、对其有用性缺乏信心（21.7%）和缺乏认识（19.7%）。大多数医生（70.8%）认为全球风险方程存在局限性；89.8%认为方程忽略了重要的风险因素，66.5%认为它们不能用于老年患者。只有 46.4%的医生表示他们当地的医疗保健框架足以进行 CVD 的一级预防，而 67.2%的医生表示其足以进行 CVD 的二级预防。
相当一部分医生报告称他们在 CVD 一级预防中使用了临床指南。然而，时间限制、缺乏感知到的有用性和知识不足是不使用 CVD 预防指南或全球 CVD 风险评估工具的常见原因。
