Global cardiovascular risk assessment: a national training course for General Practitioners

Abstract

Abstract Background Identification of high risk individuals is one of the main goals of the primary prevention of cardiovascular disease (CVD) and constitutes the basis for implementing actions aiming at reducing modifiable risk factors at individual level through changing life styles or drug interventions. The most appropriate method for identifying high risk individuals is the absolute risk assessment, a probability indicator of incidence, predictable on the basis of risk factors levels. Objectives The CUORE project score of the National Institute of Health-ISS is adopted in Italy; since 2007 ISS has implemented a national training course for General Practitioners-GPs with the aim of supporting and facilitating the use of CVD risk assessment in clinical practice as a preventive action in the general population. Results The training course is based on five sequential packages linked to educational credits: packages 1-2 facilitate the adoption of standardised methodologies for the assessment of CVD risk score; in package 3 patients are invited by GPs to assess the risk score; packages 4-5 evaluate and discuss data collected with GPs and stakeholders. A cascade training was implemented: ISS personnel provided training to local GPs who in turn provided the same training to other GPs. Two manuals for the training course were published. Since 2007 about 4,300 GPs were trained; about 320,000 10-year CVD risk assessments were performed in 260,000 men and women aged 35-69 years. Feedback was provided to all GPs participating to the 4th-5th packages of the training courses. Conclusions Implementation of the training course for the use of CVD risk assessment in the population represents a primary preventive action according to the recommendation of the EU Guideline on CVD prevention. The collected data may play an important role in the identification of strengths and weaknesses of preventive actions and represents the first step to improve good clinical practices standards.