Cardiovascular disease in primary care: concordance and risk reduction

Abstract

Computer simulation of electrical activity in the heart during the onset of cardiac arrest. Instead of regular activity controlled by the pacemaker of the heart, electrical activation (shown in red) has looped around into a spiral that will fragment, resulting in lethal electrical anarchy. This type of computational model gives a powerful insight into the mechanisms of normal and abnormal electrical activity in the heart while reducing the need for experiments using animal tissue. Taking medication is arguably one of the most common behavioural changes that GPs and other healthcare professionals require patients to make. Yet taking medicines is a complex behaviour, involving at least three stages — prescribing, dispensing, and the actual taking of the medication — that must all be effectively carried out for treatment to be successful, and in all of which personal and interpersonal factors, and the exchange and use of information play important parts. The impact on patients who fail to take their medicines correctly can be devastating in terms of their health and quality of life, and the burden to them and to society includes the cost of poorly managed risk factors, under treated symptoms, poor health outcomes, and inefficient use of NHS resources. A recent Cochrane review, Interventions for Enhancing Medicine Adherence , concluded that improved adherence to prescribed medication may have a greater impact on clinical outcomes than improvement in treatments.1 The …