Preventing recurrent coronary heart disease

BMJ 1998;316:1400-1401 ( 9 May )

Editorials

Preventing recurrent coronary heart disease

We need to attend more to implementing evidence based practice

General practice pp 1430, 1434

The first 150 words of the full text of this article appear below.

Following the publication of several recent large studies (4S, CARE, and WOSCOPS), there is little doubt about the importanceof prevention in patients with coronary heart disease, thoughcontroversy still exists about its value in patients without symptoms.General practitioners are in a favourable position to take onthe task of secondary prevention, since most have a continuingrelationship with their patients, and these patient contacts offeropportunities for measuring cardiovascular risk factors. Nevertheless,preventive care in general practice is haphazard, ¹ ² andin this issue Campbell et al confirm this shortfall (p 1430).³The question that therefore arises is how to implement the newevidence on preventing coronary heart disease effectively in generalpractice.

An audit in 95 practices in the Netherlands showed that many general practitioners had a critical attitude towards integratingprevention into practice⁴ and that few practices were sufficientlywell organised to provide effective preventive services. Thus,efforts to . . . [Full text of this article]

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