Vos Hedwig M M, Van Delft Diane H W J M, De Kleijn Miriam J J, Nielen Markus M J, Schellevis François G, Lagro-Janssen Antoine L M
Department of Primary and Community Care, Gender and Women's Health, Radboud UMC, Nijmegen, The Netherlands.
J Eval Clin Pract. 2014 Aug;20(4):478-85. doi: 10.1111/jep.12179. Epub 2014 Jun 7.
RATIONALE, AIMS AND OBJECTIVES: In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective prevention of cardiometabolic diseases before and after the introduction of the guideline and to study the effect of GP gender on these attitudes and working methods.
We compared attitudes and working methods in prevention of cardiometabolic diseases in a cross-sectional survey among Dutch GPs in 2013 to the results of a comparable study performed in 2008.
Both in 2008 and 2013 30% responded. In 2013, more GPs reported to actively invite patients for preventive measurements. Thirty per cent of the GPs implemented the module cardiometabolic risk. In 2013, less GPs reported that it is worthwhile to make an effort to detect patients at increased risk for cardiometabolic diseases, and more GPs suggested that prevention may be performed by other stakeholders compared with 2008. Financial support and evidence for prevention programmes were mentioned as main facilitators for prevention. In 2013, more male than female GPs actively invite patients for preventive measurements.
More GPs report active preventive working methods after the introduction of the Prevention Consultation guideline, but only 30% implemented the guideline. More male than female GPs actively invite patients for preventive measurements. Compared with 2008 less GPs think it is worthwhile to make an effort to detect patients at increased risk and more GPs are willing to delegate preventive actions to other health institutions in 2013. As financial support and evidence for prevention are important facilitators for prevention, further research of the effectiveness of the guideline in preventing cardiometabolic diseases is necessary, and political choices have to be made in order to financially facilitate selective prevention in general practice.
原理、目的与目标：2011年，荷兰引入了预防咨询指南中的心血管代谢风险模块，以预防心血管代谢疾病。我们旨在比较荷兰全科医生（GP）在该指南引入前后对心血管代谢疾病选择性预防的态度和工作方法，并研究GP性别对这些态度和工作方法的影响。
我们在2013年对荷兰GP进行的横断面调查中，比较了心血管代谢疾病预防方面的态度和工作方法，与2008年进行的一项类似研究结果。
2008年和2013年的回复率均为30%。2013年，更多的GP报告积极邀请患者进行预防性测量。30%的GP实施了心血管代谢风险模块。2013年，报告称努力发现心血管代谢疾病风险增加患者是值得的GP较少，与2008年相比，更多的GP认为预防可由其他利益相关者进行。预防项目的资金支持和证据被提及为预防的主要促进因素。2013年，积极邀请患者进行预防性测量的男性GP多于女性GP。
预防咨询指南引入后，更多的GP报告采用积极的预防工作方法，但只有30%实施了该指南。积极邀请患者进行预防性测量的男性GP多于女性GP。与2008年相比，2013年较少的GP认为努力发现风险增加患者是值得的，更多的GP愿意将预防行动委托给其他医疗机构。由于预防的资金支持和证据是预防的重要促进因素，有必要进一步研究该指南在预防心血管代谢疾病方面的有效性，并且必须做出政治选择，以便在经济上促进全科医疗中的选择性预防。
