Implementering af kliniske vejledninger i almen praksis. Effekten af journal-audit og efteruddannelse på behandlingen af kardiovaskulaere risikofaktorer hos patienter
med og uden type 2-diabetes mellitus
Engelsk titel: Implementation of clinical guidelines in general practice. The effect of journal audit and continuing education for the treatment of cardiovascular risk factors in patients with
and without type 2 diabetes
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Författare:
Madsbad S
;
Lytken Larsen M
;
Adeler HF
;
Kryhlmand M
;
Westergaard M
Email: sten.madsbad@hh.hosp.dk
Språk: Dan
Antal referenser: 20
Dokumenttyp:
Artikel
UI-nummer: 06041113
Sammanfattning
Introduction: The objectives of this study were, first, to describe the status of implemention of clinical guidelines for prevention of ischaemic heart disease in subjects with arterial hypertension, dyslipidemia and type 2 diabetes, but without known cardiovascular disease, and, second, to describe the changes in treatment following journal audit and education of GPs. Material and methods: 230 general practitioners (GPs) were invited to include 20 consecutive at-risk patients. One year after the first data collection of 3,555 patients by 182 GPs, a new set of 3,023 patients was collected by 170 GPs from a new patient population. In the period between the two surveys, the GPs were educated through workshops and an international meeting focusing on cardiovascular risk factor treatment. Results: The quality of the care being delivered was suboptimal. Approximately 15-40% of the patients had obtained the treatment goals for hypertension, dyslipidemia and type 2 diabetes. Some improvement was demonstrated following education and journal audit, but a gap still exists between the recommended treatment and the treatment patients actually receive. Conclusion: There is a need for improvement in the implementation of clinical guidelines focusing on diabetes and cardiovascular disease.