scholarly journals Secondary Pharmacotherapeutic Prevention among German Primary Care Patients with Peripheral Arterial Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Uwe Müller-Bühl ◽  
Gunter Laux ◽  
Joachim Szecsenyi
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Population Based ◽  
Lipid Lowering ◽  
Channel Blockers ◽  
Prescription Rates ◽  
Primary Care Patients ◽  
Peripheral Arterial ◽  
Lipid Lowering Agents

Background. The aim of the study was to determine the secondary preventive medical supply of patients with peripheral arterial disease (PAD) in German primary care.Methods and Results. A population-based case control study was conducted using electronic medical records of patients extracted from the CONTENT primary care database of Heidelberg, Germany, between April 2007 and March 2010. The prescription rates of cardiovascular medication among symptomatic PAD patients were analysed by means of the ATC classification and compared with those of patients with cardiovascular disease (CVD). 479 cases with PAD and 958 sex- and age-matched control CVD patients were identified. PAD patients showed significantly lower prescription rates for cardiac agents (21.7% versus 37%),β-blockers (50.1% versus. 66.2%), and lipid-lowering agents (50.3% versus 55.9%) compared to CVD patients. In contrast, significantly more prescriptions of antidiabetic agents (28.2% versus 20.3%), particularly insulin and analogues (12.5% versus 8%), and calcium channel blockers (29.2% versus 24.3%) were found in PAD patients. Low-dose aspirin use among both PAD and CVD patients was underestimated, as it is available without a prescription.Conclusions. Optimal pharmacotherapeutical care of patients with PAD requires more intensive cardioprotective medication in primary care settings.

scholarly journals Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study

2020 ◽  
Vol 41 (1) ◽  
pp. 61-67
Author(s):  
Tolga Vural ◽  
Makbule Neslişah Tan ◽  
Mehtap Kartal ◽  
Azize Dilek Güldal
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Population Based ◽  
Population Based Study ◽  
Peripheral Arterial

Reply to “Prevalence of symptomatic and asymptomatic peripheral arterial disease in primary care patients”

2004 ◽  
Vol 175 (1) ◽  
pp. 185-186
Author(s):  
David Pittrow ◽  
Jens R. Allenberg ◽  
Harald Darius ◽  
Roman Haberl ◽  
Stefan Lange ◽  
...  
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Primary Care Patients ◽  
Peripheral Arterial

High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study

2004 ◽  
Vol 172 (1) ◽  
pp. 95-105 ◽  
Author(s):  
Curt Diehm ◽  
Alexander Schuster ◽  
Jens R. Allenberg ◽  
Harald Darius ◽  
Roman Haberl ◽  
...  
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Co Morbidity ◽  
High Prevalence ◽  
Primary Care Patients ◽  
Peripheral Arterial

Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Klein-Weigel ◽  
Gutsche-Petrak ◽  
Wolbergs ◽  
Köning ◽  
Flessenkamper
Keyword(s):  
Peripheral Arterial Disease ◽  
Oral Anticoagulants ◽  
Arterial Disease ◽  
Disease Stage ◽  
Channel Blockers ◽  
Medical Doctors ◽  
Vascular Surgeon ◽  
Medical Prevention ◽  
Number Of Patients ◽  
Peripheral Arterial

Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeon’s awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.

scholarly journals Platelet aggregation inhibitor prescription for newly diagnosed peripheral arterial disease in the Netherlands: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041715
Author(s):  
Aarent RT Brand ◽  
Eline Houben ◽  
Irene D Bezemer ◽  
Frank L J Visseren ◽  
Michiel L Bots ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
The Netherlands ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Free Text ◽  
Newly Diagnosed ◽  
Patient Journey ◽  
P2y12 Inhibitors ◽  
Peripheral Arterial

ObjectivesPharmacological treatment of peripheral arterial disease (PAD) comprises of antiplatelet therapy (APT), blood pressure control and cholesterol optimisation. Guidelines provide class-I recommendations on the prescription, but there are little data on the actual prescription practices. Our study provides insight into the prescription of medication among patients with PAD in the Netherlands and reports a ‘real-world’ patient journey through primary and secondary care.DesignWe conducted a cohort study among patients newly diagnosed with PAD between 2010 and 2014.SettingData were obtained from the PHARMO Database Network, a population-based network of electronic pharmacy, primary and secondary healthcare setting records in the Netherlands. The source population for this study comprised almost 1 million individuals.Participants‘Newly diagnosed’ was defined as a recorded International Classification of Primary Care code for PAD, a PAD-specific WCIA examination code or a diagnosis recorded as free text episode in the general practitioner records with no previous PAD diagnosis record and no prescription of P2Y12 inhibitors or aspirin the preceding year. The patient journey was defined by at least 1 year of database history and follow-up relative to the index date.ResultsBetween 2010 and 2014, we identified 3677 newly diagnosed patients with PAD. Most patients (91%) were diagnosed in primary care. Almost half of all patients (49%) had no APT dispensing record. Within this group, 33% received other anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant). Mono-APT was dispensed as aspirin (40% of patients) or P2Y12 inhibitors (2.5% of patients). Dual APT combining aspirin with a P2Y12 inhibitor was dispensed to 8.5% of the study population.ConclusionHalf of all patients with newly diagnosed PAD are not treated conforming to (international) guideline recommendations on thromboembolism prevention through APT. At least 33% of all patients with newly diagnosed PAD do not receive any antithrombotic therapy. Evaluation and improvement of APT prescription and thereby improved prevention of (secondary) cardiovascular events is warranted.

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