Literature DB >> 17823228

A cross sectional survey of secondary prevention measures in patients with peripheral arterial disease in primary care.

Alison Dunkley1, Margaret Stone, Robert Sayers, Azhar Farooqi, Kamlesh Khunti.   

Abstract

BACKGROUND: The National Service Framework for coronary heart disease (CHD) defines standards for the secondary prevention of cardiovascular disease in at risk individuals, including those with peripheral arterial disease (PAD). AIM: To assess current standards of secondary prevention and health monitoring in patients with PAD following a vascular procedure, and additionally compare care in patients with and without diagnosed CHD.
METHODS: Indicators for this cross sectional survey were identified from national recommendations and evidence. A retrospective review was conducted of general practitioner records, for patients who were treated in hospital for PAD.
RESULTS: Data were collected for 103 patients from 42 practices. Overall, prescribing was well achieved for antiplatelets but poor for statins. Standards of assessment of blood pressure, smoking status, and smoking cessation advice were high. However, approximately only half of the patients received advice about exercise or had their body mass index checked. Furthermore, for all indicators, standards of care for patients who additionally had a diagnosis of CHD were better than for patients without CHD.
CONCLUSION: The cross sectional survey suggested the treatment received by some patients with established PAD is substandard. There is considerable potential to increase secondary prevention of CHD in patients with PAD disease in primary care.

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Mesh:

Year:  2007        PMID: 17823228      PMCID: PMC2600001          DOI: 10.1136/pgmj.2007.060806

Source DB:  PubMed          Journal:  Postgrad Med J        ISSN: 0032-5473            Impact factor:   2.401


  10 in total

1.  ABC of arterial and vascular disease. Secondary prevention of peripheral vascular disease.

Authors:  S Tierney; F Fennessy; D B Hayes
Journal:  BMJ       Date:  2000-05-06

2.  Improving aspirin prophylaxis after myocardial infarction in primary care: collaboration in multipractice audit between primary care audit group and health authority.

Authors:  K Khunti; R Sorrie; S Jennings; A Farooqi
Journal:  BMJ       Date:  1999-07-31

3.  Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients.

Authors:  S Yusuf; P Sleight; J Pogue; J Bosch; R Davies; G Dagenais
Journal:  N Engl J Med       Date:  2000-01-20       Impact factor: 91.245

4.  Secondary prevention in coronary heart disease: baseline survey of provision in general practice.

Authors:  N C Campbell; J Thain; H G Deans; L D Ritchie; J M Rawles
Journal:  BMJ       Date:  1998-05-09

Review 5.  Exercise for intermittent claudication.

Authors:  G C Leng; B Fowler; E Ernst
Journal:  Cochrane Database Syst Rev       Date:  2000

6.  Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.

Authors: 
Journal:  BMJ       Date:  2002-01-12

7.  Missed opportunities to treat atherosclerosis in patients undergoing peripheral vascular interventions: insights from the University of Michigan Peripheral Vascular Disease Quality Improvement Initiative (PVD-QI2).

Authors:  Debabrata Mukherjee; Prasanth Lingam; Stanley Chetcuti; P Michael Grossman; Mauro Moscucci; Ann E Luciano; Kim A Eagle
Journal:  Circulation       Date:  2002-10-08       Impact factor: 29.690

Review 8.  Oral antiplatelet therapy in cerebrovascular disease, coronary artery disease, and peripheral arterial disease.

Authors:  Huyen Tran; Sonia S Anand
Journal:  JAMA       Date:  2004-10-20       Impact factor: 56.272

9.  Intensive blood pressure control reduces the risk of cardiovascular events in patients with peripheral arterial disease and type 2 diabetes.

Authors:  Philip S Mehler; Joseph R Coll; Raymond Estacio; Anne Esler; Robert W Schrier; William R Hiatt
Journal:  Circulation       Date:  2003-02-11       Impact factor: 29.690

10.  MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial.

Authors: 
Journal:  Lancet       Date:  2002-07-06       Impact factor: 79.321

  10 in total

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