POSSIBILITY OF IMPROVING THE QUALITY OF DIAGNOSIS AND TREATMENT OF HYPERTENSION AND DYSLIPIDEMIA BY PHYSICIANS EDUCATION

Abstract

Objective: To study the possibility of improving the educational level of primary health care physicians (cardiologists and internists) of Kursk city (Russia) aimed at improving the quality of diagnosis and treatment of hypertension and dyslipidemia in the short and long term. Design and method: The educational project (EP) covered all primary care physicians and cardiologists of Kursk (n = 144). During 1 year several seminars were held for physicians by the experts of national guidelines on hypertension and dyslipidemia. The criteria for the efficacy of EP was the achievement of target levels of blood pressure (BP) and total cholesterol, as well as positive changes of physicians actions on the diagnosis and treatment of hypertension and dyslipidemia. For this reason physician records from 300 randomly selected ambulatory cards was analysed before the start of the EP and following 1 and 3 years. Results: Following 3 years after the EP, the frequency of achieving target BP was 39.6% (n = 119), which is significantly higher than before the project – 31,6%(n = 95), p < 0.05, but lower than 1 year after the EP - 51% (n = 153), p < 0,01). The frequency of achievement of the target level of total cholesterol after 3 years was 38.3% (n = 115), significantly higher than before the start of the project 9,3%(p < 0.01), and differs a little from the figures obtained after 1 year- 43,3% (n = 130), p 0,05. There were the improvement of situation with the investigations aimed at revealing of target organ damages. So, after 3 years, heart ultrasound has appointed 24.7% (n = 74) of doctors, significantly higher than before the start of the EP (p < 0.001), but lower than 1 year after the EP (p < 0.05). Impressive increase of investigations to reveal microalbuminuria was found - after 3 years −32,7% (n = 98), which is significantly higher than before the project (p < 0.001) and after 1 year (p < 0.001). Conclusions: EP demonstrated not only short, but long-term efficacy. However, given a decline in several important variables of efficacy of education it should be done on systematic basis.