University Hospital Galway and SAOLTA University Health Care Group; National University of Ireland, Galway, Ireland.
National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, Ireland.
Ir J Med Sci. 2022 Apr;191(2):777-784. doi: 10.1007/s11845-021-02619-x. Epub 2021 Apr 24.
General practice has a key role in diagnosing patients with valvular heart disease (VHD) and referring them to appropriate services.
An anonymous survey was conducted to assess the knowledge and clinical practice behaviour of Irish general practitioners (GPs) in relation to VHD. In addition to demographic data, the survey captured information in the following domains: knowledge of VHD prevalence, knowledge of contemporary VHD treatments, barriers to diagnosis, and referral patterns. To augment responses, a monetary prize (donated to charity) was offered and the survey was also disseminated using social media and by the Irish College of General Practitioners.
Valid survey responses were received from 197 GPs. The sample was well-balanced by gender, number of years in practice, and practice setting. A small proportion of GPs (16.8%) used a stethoscope to examine for VHD in all patients over 60 years, a figure that rose to 22.3% in patients over 75. Approximately half of participants (48%) felt confident in their ability to detect and diagnose VHD using a stethoscope, and 74% felt lack of access to echocardiography was a major barrier to making a VHD diagnosis. There was a high level of awareness among GPs of minimally invasive nonsurgical interventions now available for VHD treatment.
Irish GPs displayed good understanding of contemporary VHD treatment options but reported low confidence and inconsistent practices in evaluating patients for VHD. Improved access to echocardiography might help address these deficiencies, but reorganisation of services will be required in a resource-limited public health service.
全科医学在诊断瓣膜性心脏病（VHD）患者并将其转介至合适的服务机构方面发挥着关键作用。
本研究通过匿名调查评估了爱尔兰全科医生（GP）在 VHD 方面的知识和临床实践行为。除了人口统计学数据外，该调查还记录了以下领域的信息：VHD 患病率知识、当代 VHD 治疗知识、诊断障碍和转诊模式。为了补充回答，我们提供了一笔奖金（捐赠给慈善机构），并通过爱尔兰全科医生学院和社交媒体来传播该调查。
共收到 197 名 GP 的有效调查回复。该样本在性别、行医年限和执业地点方面分布均衡。一小部分 GP（16.8%）会在所有 60 岁以上的患者中使用听诊器检查 VHD，而在 75 岁以上的患者中，这一比例上升至 22.3%。大约一半的参与者（48%）对使用听诊器检测和诊断 VHD 的能力有信心，74%的人认为缺乏超声心动图是做出 VHD 诊断的主要障碍。GP 对目前用于 VHD 治疗的微创非手术干预措施有很高的认识。
爱尔兰 GP 对当代 VHD 治疗选择有很好的理解，但在评估 VHD 患者方面报告的信心较低，实践也不一致。改善对超声心动图的获取可能有助于解决这些不足，但在资源有限的公共卫生服务中，需要对服务进行重新组织。
