SCREENING FOR CARDIOVASCULAR-DISEASE AND RISK REDUCTION COUNSELING BEHAVIORS OF GENERAL-PRACTITIONERS

Background. This study presents prevalence of risk factors for cardiovascular disease in general practice patients and screening rates for risk factors. Conditions addressed include smoking, weight, alcohol intake, blood pressure, and cholesterol. Methods. Adult patients (7,160) attending 230 general practitioners in a metropolitan (Brisbane) and rural (Toowoomba) region in Queensland were recruited to a cross-sectional study. A self-administered patient questionnaire provided self-reported information on lifestyle risk factors and rates of previous screening. A doctor's questionnaire completed at the conclusion of the consultation provided information about physician knowledge of patient risk factors and details of preventive care provided in the consultation. Results. Twenty-five percent of patients reported that they smoked, 2% drank beyond defined safe limits, 40% had body mass index >24.9 (kg/m2). Doctors identified 66% of self-reported smokers, 40% of heavy drinkers, and 59% of overweight patients. Over 90% of patients reported prior blood pressure measurements in agreement with national recommendations; cholesterol screening within the past 5 years was reported by 51% of patients. Screening and/or counselling of patients in the consultation was highest for blood pressure (47%) and smoking (34%) and considerably lower for overweight (22%), alcohol (19%), and cholesterol (6%). Conclusions. Although preventive activities are being undertaken in general practice, performance of these activities is less than ideal. The barriers to undertaking these activities need to be addressed for change to occur. (C) 1994 Academic Press, Inc.