Brotons C, Server M, Pintó X, Roura P, Martín-Zurro A
Unitat d'Epidemiologia Clínica, Hospital General Universitari Vall d'Hebron, Barcelona.
Med Clin (Barc). 1997 Jan 11;108(1):9-15.
In May 1989 and June 1990, consensus conferences of treatment of hypertension and hypercholesterolemia respectively were held in Spain, at the General Division of Health Planning from the Ministry of Health. The objective of this article is to assess the effect of such conferences of physicians' knowledge, attitudes and practices.
Cross-sectional telephone survey was carried out in physicians of general medicine, family practice, internal medicine and cardiology specialties. 807 physicians were selected, 347 family physicians, 177 general practitioners, 156 cardiologists and 128 internists. A questionnaire of 30 items was designed to obtain information about demographic and professional characteristics, knowledge of the consensus conferences and attitudes related to a case of an otherwise healthy asymptomatic 48-years-old man.
The response rate was 57% (463 physicians), and 60% of physicians had knowledge about the conferences, being general practitioners the ones who had less knowledge of the conferences. The items about recommendations of diet and pharmacological treatment were property answered (about 50% of the physicians answered correctly). The mean of serum cholesterol when diet and drugs are recommended was 232 mg/dl (SD 23) (6.01 mmol/l) and 260 mg/dl (SD 25) (6.7 mmol/l) respectively. The first-choice cholesterol lowering drugs were statines. A patient was considered as hypertensive it the mean of systolic blood pressure was 149 mmHg (9.4) and the mean for diastolic blood pressure was 92 mmHg (3.8). The mean of diastolic blood pressure considered for drug treatment was 96.7 mmHg (SD 4.6). The first-choice antihypertensive drugs were angiotensin conversive enzyme inhibitors.
Diffusion of the conferences has been unequal, being general practitioners less knowledgeable about the content of the conferences. Although physicians know reasonably well the recommendations about diet and drug treatments, the attitude in practice is more aggressive than recommended. Globally, the knowledge of the contents of the conferences was acceptable, although there were differences between specialties; however the effect on clinical practice is still low.
1989年5月和1990年6月，西班牙卫生部卫生规划总局分别召开了高血压和高胆固醇血症治疗共识会议。本文的目的是评估此类会议对医生知识、态度和实践的影响。
对普通医学、家庭医学、内科和心脏病学专业的医生进行横断面电话调查。共选取807名医生，其中347名家庭医生、177名全科医生、156名心脏病专家和128名内科医生。设计了一份包含30个条目的问卷，以获取有关人口统计学和专业特征、对共识会议的了解以及对一名48岁无症状健康男性病例的态度等信息。
回复率为57%（463名医生），60%的医生了解这些会议，全科医生对会议的了解最少。关于饮食和药物治疗建议的条目回答正确（约50%的医生回答正确）。推荐饮食和药物时血清胆固醇的平均值分别为232mg/dl（标准差23）（6.01mmol/l）和260mg/dl（标准差25）（6.7mmol/l）。首选的降胆固醇药物是他汀类药物。若收缩压平均值为149mmHg（标准差9.4）且舒张压平均值为92mmHg（标准差3.8），则该患者被视为高血压患者。考虑药物治疗时舒张压的平均值为96.7mmHg（标准差4.6）。首选的降压药物是血管紧张素转换酶抑制剂。
会议的传播并不均衡，全科医生对会议内容的了解较少。尽管医生对饮食和药物治疗的建议了解得相当不错，但实际态度比推荐的更为激进。总体而言，对会议内容的了解是可以接受的，尽管各专业之间存在差异；然而，对临床实践的影响仍然较小。
