Professional paper
CARE QUALITY FOR PATIENTS WITH CORONARY ARTERY DISEASE IN FAMILY MEDICINE - GUIDELINE IMPLEMENTATION BY TAKING A GLANCE AT THE RISK FACTORS
SUNČANA VLAH
orcid.org/0000-0001-7461-5866
; Health Centre Zagreb – Istok, Zagreb, Croatia
LUCIJA MURGIĆ
orcid.org/0000-0002-4548-7612
; Health Centre Zagreb – Centar, Zagreb, Croatia
ANA NEDIĆ
; J. Juraj Strossmayer University in Osijeku, Faculty of Medicine, Osijek, General Hospital Virovitica, Virovitica, Croatia
DUBRAVKA RAČKI GRUBIŠA
; General Practice, Fažana, Croatia
VANJA LAZIĆ
orcid.org/0000-0002-9336-3534
; Health Centre Zagreb – Centar, Zagreb, Croatia
DANIEL FERLIN
orcid.org/0000-0001-6600-4344
; Istrian Health Care Centers, Croatia
LANATINA MIHALJINEC
; Health Centre Zagreb – Centar, Zagreb, Croatia
ANTE PROLIĆ
; General Practice, Sinj, Croatia
VALERIJA BRALIĆ LANG
orcid.org/0000-0002-9142-1569
; General Practice, Zagreb, Croatia
JELENA EVIĆ
; General Practice, Zagreb, Croatia
JOSIP BULJAN
orcid.org/0009-0003-4675-473X
; General Practice, Velika Kopanica, Croatia
ĐURĐICA KAŠUBA LAZIĆ
; University of Zagreb, Faculty of Medicine, Andrija Štampar School of Public Health, Chair of Family Medicine, Zagreb, Croatia
Abstract
Introduction: Patients with coronary artery disease represent a challenge in each family medicine practice because of many comorbidities and the application of secondary prevention measures which represent a tool for tracking and simultaneously correcting risk factors related to the patient, his surroundings and lifestyle. Objective: Explore the effectiveness of family medicine specialists in applying secondary prevention measures in cardiovascular diseases and to find a solution for improving quality of care. Participants and Methods: This observational study, was conducted in 2017. under nine specialised family medicine practices throughout Croatia and included 169 patients who suffered from myocardial infarction and/or underwent percutaneous coronary intervention and/or bypass surgery. Blood pressure, LDL cholesterol and body mass index were measured and it was examined whether the participants were abiding to the advised healthy habits (nonsmoking, physically active, good diet, regular use of medicaments according to the guidelines). Adjustment to the new lifestyle was measured with Likert scale (1-5) and the same scale was used to asses physicians satisfaction with transparency of electronic health record data. Results: 63.2% of participants had recommended values for blood pressure, 19.4% for LDL cholesterol and 25.3% had a normal body mass index according to the guidelines. 25.1% of participants continued to smoke and 43.2% continued alcohol consumption. In terms of diet, a change was observed in 63.7% and physical activity increase in 63.4% of participants. In most cases, after coronary incident, physician consulted them regarding lifestyle changes. Family medicine specialists were mostly pleased with the content and the amount of data in electronic health records, but not with their transparency and ease of use in everyday, usually time constrained, patient - doctor consultations. A software application Adobe Illustrator® was used to visually represent the relevant risk factors which could provide more effective control for conducting secondary prevention measures. Conclusion: The care for coronary artery disease patients in family medicine is very complex, and a part of it is related to providing effective measures of secondary prevention which are of crucial importance. Therefore it is imperative to plan ahead and allow sufficient consultation time to obtain control over the risk factors and make timely changes according to the guidelines. Research results have shown that not all risk factors are within recommended values and one of the reasons could be the lack of clear presentation in the electronic health record. Better quality of care could be achieved with the proposed visual solution using pictures that allows the family physician fast access to the patient’s “profile” and improves efficiency of every consultation despite its constrained duration in everyday conditions.
Keywords
cardiovascular disease; myocardial infarction; guidelines; lifestyle; secondary prevention; family medicine
Hrčak ID:
224702
URI
Publication date:
6.9.2019.
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