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KNOWLEDGE AND IMPLEMENTATION OF CARDIOVASCULAR RISK SCORES BY FAMILY PHYSICIANS

Author Block M Matangi, D Armstrong, J Niznick, R Del Grande, P Hollett, P De Young

Kingston, Ontario

Abstract:
BACKGROUND: To determine the knowledge and implementation of the various cardiovascular risk scores (CVRS) available to a family doctor (FD) in South eastern Ontario.
METHODS: The authors represent community cardiovascular specialists (CCS) in southeastern Ontario, Canada. FDs that refer to these CCS were contacted by FAX or letter and were first asked a series of questions of their knowledge of the various CVRS. A second set of questions were then asked as to what method(s) the FD actually used to assess cardiovascular risk and prescribe Statins. The questionnaire was anonymous and the FD was asked to indicate what they actually use to assess cardiovascular risk and not what they think they should be using. CVRS knowledge was classified as, 1. Any, 2. FRSC (Framingham risk score coronary), 3. FRSG (global), 4. Reynolds, 5. JUPITER or 6. ARIC. CVRS use was the same except counting risk factors to assess the need for a Statin was an option.
RESULTS: One hundred and twenty of 231 (51.9%) family physicians contacted by FAX returned the questionnaire by FAX compared to only 61 of 500 (12.5%) contacted by letter. The total surveys returned were 181. The main results can be seen in the figure below.
CONCLUSION: There is no knowledge deficit with respect to the FRS. There is a significant knowledge deficit in the CVRS requiring either hs-CRP (Reynolds risk score and JUPITER) or carotid imaging data (ARIC). What is apparent is that despite their knowledge of the FRS (coronary or global), 72% of FDs surveyed admitted that they still count risk factors when assessing the need for Statin therapy. We believe these results indicate that cardiovascular risk is likely being underestimated by FDs in southeastern Ontario and propose that since implementation appears to be the main problem a different strategy is required.