Ethical approval: Because of the study design, approval of an ethical committee was not necessary.
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Original Article
The usefulness of antiplatelet prescriptions for the identification of patients with atherothrombosis in primary care: a Dutch cross-sectional study
Article first published online: 28 JUN 2011
DOI: 10.1111/j.1365-2753.2011.01697.x
© 2011 Blackwell Publishing Ltd
Additional Information
How to Cite
van de Steeg-van Gompel, C. H. P. A., Wensing, M., Braspenning, J. and De Smet, P. A. G. M. (2012), The usefulness of antiplatelet prescriptions for the identification of patients with atherothrombosis in primary care: a Dutch cross-sectional study. Journal of Evaluation in Clinical Practice, 18: 866–871. doi: 10.1111/j.1365-2753.2011.01697.x
Conflict of interest statements: None.
Funding: This work was supported by the ‘Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie’ (the Royal Dutch Association for the Advancement of Pharmacy), The Hague, the Netherlands.
Publication History
- Issue published online: 2 JUL 2012
- Article first published online: 28 JUN 2011
- Accepted for publication: 6 April 2011
- Abstract
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Keywords:
- cardiovascular disease;
- diagnosis;
- drug therapy;
- patient identification;
- platelet aggregation inhibitors;
- primary health care
Abstract
Rationale, aims and objectives Patients with atherothrombotic cardiovascular disease (ACD) should receive specific treatments, including lipid-lowering medication. In order to optimize treatment for patients with ACD in primary care, an efficient method to identify all these patients is needed. We aimed to assess which method serves best to identify all patients with ACD in Dutch primary care: morbidity records, antiplatelet prescribing records or a combination of these.
Methods In a cross-sectional study in 45 Dutch general practices, computerized medical records of all patients with any cardiovascular disease, cardiovascular symptoms or cardiovascular medication were analysed.
Results Of the 7280 patients with a recorded indisputable indication for antiplatelet therapy, 4715 (64.8%) could be identified by means of antiplatelet prescriptions. Of the patients with a recorded indisputable indication for antiplatelets but without any antiplatelet prescription, 28.9% received a vitamin K antagonist. Of the 8718 patients with antiplatelet therapy, 5697 (65.3%) could be identified by means of a recorded indisputable or possible indication for antiplatelet therapy. Female patients, patients younger than 60 years old and patients having a recorded diagnosis of angina pectoris or diabetes had a higher risk to be missed by antiplatelet prescribing records.
Conclusion Morbidity records and prescribing records should be used both in order to identify all patients with ACD in primary care. Patients who use antiplatelet prescriptions but do not have a recorded ACD deserve extra attention, because they are either treated without a good indication for antiplatelet therapy (overtreatment) or need a correction of their morbidity records.