Efforts to close the evidence-practice gap in the management of cardiovascular risk factors in general practice: strategic or haphazard?

Abstract

Rational, aims and objectives: Guidelines for best practice management of cardiovascular disease (CVD) risk factors such as smoking, high blood pressure, high cholesterol, risky alcohol consumption, diabetes and obesity are in place in the primary care setting, yet many of these risk factors remain uncontrolled. This review examined: a) trends in the number of published provider-focussed intervention studies which aimed to improve the identification and management of modifiable CVD risk factors in primary care; b) the proportion of primary care research effort directed toward improving provider management of each CVD risk factor compared to the mortality burden associated with each risk factor in high income countries. Methods: An electronic database search of Medline, Cinahl and PsychInfo was conducted for the time period January 1 st 1999 to 31 st December 2010 to identify relevant articles. Results: There was a trend toward an increase in the number of provider-focussed interventions to improve the management of CVD risk factors in general practice over time. The proportion of research effort directed to risk factors varied between 6% for alcohol and obesity to 32% for high blood pressure. High blood pressure and smoking had the highest and second highest proportion of research effort and were ranked second and first, respectively, in terms of mortality burden. Conclusions: The allocation of research effort appears somewhat consistent with the health burden associated with the risk factors examined in this review, although an increase in smoking-related research may be needed.