For many years, the Heart Foundation has been involved in the
development of evidence based clinical practice guidelines for the
management of cardiovascular diseases and conditions, including
coronary heart disease (CHD). However, the production of guidelines
does not ensure the uptake of evidence based recommendations in
practice. This ‘management gap’ – or difference between guideline
recommendations and actual clinical practice – may contribute
significantly to the burden of CHD in Australia.
This review aims to identify gaps of clinical significance in the
management of CHD in Australian general practice. These identified
gaps will then inform future efforts to improve cardiovascular
outcomes in this setting.
A literature and key documents search was undertaken to identify
Australian data relating to cardiovascular disease, current practice
and treatment gaps in the general practice setting. A number of
gaps in the management of CHD exist in Australia. Addressing
these gaps will improve patient outcomes. While the reasons for
the management gaps are complex and multifaceted, the Heart
Foundation will use this information to focus its messages and
activities in general practice. The key messages developed present
opportunities for improved clinical management of CHD in general
Coronary heart disease (CHD) represents a major health burden in Australia, affecting an estimated 334 500 Australians1 and claiming nearly 23 000 Australian lives in 2006.2 In addition, many more Australians are at risk of CHD, with 90% of adults (about 13.1 million people) in Australia having at least one modifiable risk factor and one in 4 people having three or more.3 The prevalence of individual risk factors is high, and unfavourable trends have been observed with insufficient physical activity, excess weight and diabetes over the past 20 years.3
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