25 Jul Women and Young People Less Likely to Have Coronary Heart Disease Managed According to Guidelines
MedicalResearch.com Interview with:
Dr. Lee
Dr Crystal Lee BMedSc(Hons), MIPH, PhD, MBiostat
Senior Research Fellow
School of Psychology and Public Health
La Trobe University
Honorary Research Fellow
The Boden Institute of Obesity, Nutrition,
Exercise & Eating Disorders
The University of Sydney
Adjunct Senior Research Fellow
School of Public Health | Curtin University
MedicalResearch.com: What is the background for this study?
Response: Coronary heart disease (CHD) is a leading cause of death and disability worldwide. Primary care has been shown to play an important role in the secondary prevention of cardiovascular disease. Yet, studies in Australia and elsewhere from as far back as two decades ago identified gaps in the management of CHD patients in primary care.
We analysed records of 130,926 patients with a history of CHD from 438 general practices across Australia to determine whether sex disparities exist in the management of CHD according to current clinical guidelines.
MedicalResearch.com: What are the main findings?
Response: We found under-prescribing of recommended medications, lack of risk factor monitoring, and not achieving treatment targets remain widespread in people with Coronary heart disease. Importantly, women and people aged less than 45 years are less likely to have their condition managed according to guidelines.
MedicalResearch.com: What should readers take away from your report?
Response: Recommendations for the secondary prevention of CHD apply to all people with CHD. Patients with CHD should be managed according to guidelines regardless of their sex or age. The general practice management plan (GPMP) for CHD is a tool for the management of patients with CHD in primary care. Patients with CHD could ask their doctor to prepare a GPMP or review their existing GPMP. Doctors could make use of the opportunity to discuss or remind patients the benefits of cardiovascular medications, smoking cessation, maintaining healthy weight etc.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Research is needed to better understand the reasons for the persistence of the CHD management gaps and identify new ways to address these gaps. For example, our study lacked drug dispensing data, which could have informed whether medication nonadherence or ineffective treatment led to blood pressure and cholesterol targets not met in people prescribed with the relevant recommended medications. Moreover, missing information on risk factors assessed during consultation could have been due to lack of documentation rather than lack of assessment.
MedicalResearch.com: Is there anything else you would like to add?
Response: There is a misconception that CHD only affects older men but almost half of those who die from the disease are women. Sex disparities in the management of CHD in primary care needs addressing to improve the outcomes for all affected people and their families.
This project was supported by a National Heart Foundation of Australia Vanguard Grant.
Lee CMY, Mnatzaganian G, Woodward M, et al
Sex disparities in the management of coronary heart disease in general practices in Australia
Heart Published Online First: 23 July 2019. doi: 10.1136/heartjnl-2019-315134
Citations:
Lee CMY, Mnatzaganian G, Woodward M, et al
Sex disparities in the management of coronary heart disease in general practices in Australia
Heart Published Online First: 23 July 2019. doi: 10.1136/heartjnl-2019-315134
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Last Updated on July 25, 2019 by Marie Benz MD FAAD