Tannenbaum T N, Sampalis J S, Battista R N, Rosenberg E R, Joseph L
Department of Medicine, Montreal General Hospital.
CMAJ. 1990 Nov 1;143(9):875-81.
We surveyed primary care physicians in Canada to determine their current practices regarding the detection and treatment of hyperlipidemia in asymptomatic adults 20 years of age or more and to determine the role of selected patient characteristics (age, sex and the presence of coronary heart disease [CHD] risk factors) in their management decisions. The self-administered questionnaire was completed by 428 of 804 family physicians and general practitioners. The proportion of physicians who reported having tested at least 50% of their adult patients varied from 29% to 85% and was related to the number of CHD risk factors present and the patient's age. The proportion of respondents who reported starting dietary or drug therapy among patients with a cholesterol level of 6.2 mmol/L or less increased as the number of CHD risk factors increased and was not related to patient age or sex. According to the factors examined our results suggest that primary care physicians in Canada select patients for screening and treatment mainly on the basis of CHD risk factors present and that their approach is more conservative than that recommended by the Canadian and US consensus conferences.
我们对加拿大的基层医疗医生进行了调查,以确定他们目前针对20岁及以上无症状成年人高脂血症的检测和治疗方法,并确定特定患者特征(年龄、性别和冠心病[CHD]危险因素的存在情况)在他们管理决策中的作用。804名家庭医生和全科医生中有428人完成了这份自填式问卷。报告对至少50%的成年患者进行过检测的医生比例从29%到85%不等,且与存在的冠心病危险因素数量和患者年龄有关。报告在胆固醇水平为6.2 mmol/L或更低的患者中开始饮食或药物治疗的受访者比例随着冠心病危险因素数量的增加而上升,且与患者年龄或性别无关。根据所研究的因素,我们的结果表明,加拿大的基层医疗医生主要根据存在的冠心病危险因素来选择患者进行筛查和治疗,并且他们的方法比加拿大和美国共识会议所推荐的更为保守。