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Issues in the assessment of cardiovascular risk in selected general practices in Canterbury, New Zealand.

AIMS
The aim was to audit patient records at selected general practices in Canterbury, New Zealand to assess the potential: (a) to improve identification and management of people with risk factors for cardiovascular disease (CVD); and (b) to develop a geographically distinct community database of CVD risk factor prevalence that could be used to plan public health programmes to improve cardiovascular health.


METHODS
Patient records were audited in three general practices in a Canterbury rural town and information on cardiovascular risk factors recommended for the screening and management of CVD by the New Zealand Guidelines Group was extracted and entered into an electronic database. The data was analysed to assess the extent of recording of information on recommended risk factors.


RESULTS
Most patient records contained information on smoking, blood pressure and lipid profiles. Low levels of information recording were found for physical activity, body mass index (BMI), and family history. There were statistically significant differences between general practices in the type and coverage of information recorded, even for patients with diagnosed cardiovascular disease. Because of deficiencies in information, it was not possible to calculate CVD risk using the guidelines for 43% of patients. Some practices remain reliant on paper records which make it extremely difficult to undertake a systematic programme of screening and management of CVD risk factors.


CONCLUSIONS
Before it is practical to undertake a systematic screening programme for CVD risk factors in primary care, it is necessary to reduce reliance on paper records and to fully implement computerised patient management systems that allow for information storage and retrieval. In addition, it is essential to improve the systematic collection of key information in primary care that is used to assess risk of CVD.