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Absolute cardiovascular risk assessment by Australian early-career general practitioners: a cross-sectional study

Family Medicine and Community Health 2023年第3期11卷 45-61页

作者： Toby Morgan Anna Ralston Andrew Davey Elizabeth G Holliday Mark Nelson Alison Fielding Mieke van Driel Amanda Tapley Dominica Moad Jean Ball jennifer presser Neil Spike Parker Magin School of Population Health University of New South Wales Faculty of MedicineKensingtonNew South WalesAustralia NSW&ACT Research and Evaluation Unit GP Synergy Ltd-NewcastleMayfield WestNew South WalesAustralia School of Medicine and Public Health The University of NewcastleCallaghanNew South WalesAustralia University of Tasmania Menzies Institute for Medical Research HobartTasmaniaAustralia University of Tasmania School of Medicine HobartTasmaniaAustralia General Practice Clinical Unit The University of Queensland Faculty of MedicineBrisbaneQueenslandAustralia Clinical Research Design and Statistical Support Unit(CReDITSS) The University of Newcastle Hunter Medical Research InstituteNew LambtonNew South WalesAustralia Department of General Practice and Primary Health Care The University of MelbourneCarltonVictoriaAustralia Monash University Faculty of Medicine Nursing and Health Sciences ClaytonVictoriaAustralia

Objective To determine the prevalence and associations of general practice registrars’performing absolute cardio-vascular risk(ACVR)assessment(ACVRa).Design A cross-sectional study employing data(2017–2018)from the Registrar Clinical Encounters in Training project,an ongoing inception cohort study of Australian GP *** outcome measure was whether an ACVRa was *** employed univariable and multivariable *** was conducted for all patient problems/diagnoses,then for an‘at-risk’population(specific problems/diagnoses for which ACVRa is indicated).Setting Three GP regional training organisations(RTOs)across three Australian *** GP registrars training within participating *** 1003 registrars(response rate 96.8%)recorded details of 69105 problems either with Aboriginal and/or Torres Strait patients aged 35 years and older or with non-Indigenous patients aged 45 years and *** these problems/diagnoses,1721(2.5%(95%CI 2.4%to 2.6%))involved an *** ACVRa was‘plausibly indicated’in 10384 problems/*** these,1228(11.8%(95%CI 11.2%to 12.4%))involved ***‘all problems/diagnoses’,on multivariable analysis female gender was associated with reduced odds of ACVRa(OR 0.61(95%CI 0.54 to 0.68)).There was some evidence for Aboriginal and/or Torres Strait Islander people being more likely to receive ACVRa(OR 1.40(95%CI 0.94 to 2.08),p=0.10).There were associations with variables related to continuity of care,with reduced odds of ACVRa:if the patient was new to the registrar(OR 0.65(95%CI 0.57 to 0.75)),new to the practice(OR 0.24(95%CI 0.15 to 0.38))or the problem was new(OR 0.68(95%CI 0.59 to 0.78));and increased odds if personal follow-up was organised(OR 1.43(95%CI 1.24 to 1.66)).For‘ACVRa indicated’problems/diagnoses,findings were similar to those for‘all problems/diagnoses’.Association with Aboriginal and/or Torres Strait Islander status,however,was significant at p<0.05(OR 1.60(95%CI 1.04 to 2.46))a

关键词： sectional continuity Island

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