Barriers to Detecting and Treating Hypercholesterolaemia in Patients with Ischaemic Heart Disease: Primary Care Perceptions

Overview

Journal Br J Gen Pract

Specialty Public Health

Date 2005 Jul 12

PMID 16004739

Citations 11

Authors

James Hickling

Stephen Rogers

Irwin Nazareth

Affiliations

Soon will be listed here.

Abstract

Background: Treating hypercholesterolaemia in patients with ischaemic heart disease can significantly reduce vascular deaths and events. Many such patients, however, do not receive effective treatment for hypercholesterolaemia.

Aim: To ascertain the barriers to the detection and treatment of hypercholesterolaemia in patients with ischaemic heart disease as seen by primary care teams.

Design Of Study: Qualitative study using the nominal group technique.

Setting: General practice teams in the North Thames region of the Medical Research Council General Practice Research Framework.

Method: The main outcomes measures used were identification of the barriers to the detection and treatment of hypercholesterolaemia together with relative rankings.

Results: Fourteen individual barriers were identified. The main barriers were: organisational barriers within general practices; confusing and conflicting guidelines from external sources; errors and omissions by GPs; communication problems at the interface between secondary and primary care; and reluctance by patients to take medication.

Conclusions: The reasons for suboptimal detection and treatment of hypercholesterolaemia are complex and act at various levels. Interventions to improve the management of this condition must address these barriers in order to be successful.

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