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Objective. To describe the management of dyslipidaemia in patients with high risk of cardiovascular disease (CVD) and patients with a history of CVD identified by screening for diabetes in general practice in Denmark, concentrating on prescription of lipid-lowering drugs. Moreover, to analyse predicting factors for starting lipid-lowering drugs related to patient and general practice characteristics. Design. Population-based cross-sectional study with follow-up. Setting. A total of 139 general practices from three of five Danish regions, totalling 216 GPs. Subjects. The study population comprised 4986 patients with a high risk of CVD and dyslipidaemia and 764 patients with a history of CVD and dyslipidaemia out of a population of 16 572 patients who completed screening for diabetes but were cleared for diabetes in the ADDITION study. Results. Of patients with a high risk of CVD and dyslipidaemia not receiving lipid-lowering drugs at the time of screening (n = 4823), 20% started lipid-lowering therapy within the follow-up period (median 2.1 years). This percentage was 45% (n = 536) for patients with CVD and dyslipidaemia (median follow-up period 1.6 years). Age over 50, high cholesterol, impaired fasting glucose and/or impaired glucose tolerance, minor polypharmacy, use of heart/circulation drugs, and cholesterol measurements after screening predicted the prescription of lipid-lowering drugs for patients at high risk of CVD. For patients with CVD, male gender, high cholesterol and use of heart/circulation drugs predicted the prescription of lipid-lowering drugs. No general practice characteristics were associated with different prescription habits. Conclusion. There is a gap between the recommended lipid-lowering drug therapy and current practice, with a substantial under-treatment and a considerable delay in the first prescription of lipid-lowering drugs. [ABSTRACT FROM AUTHOR]

Objective - To describe the use and level of HbA1c in a large unselected Type 2 diabetic population in Denmark. In addition, to describe the characteristics of the patients and the general practitioners in relation to the monitoring of HbA1c. Design - Data were collected from public data files for the period January 1993 to December 1997. Setting - The County of Vejle with a background population of 342597 citizens, 303 250 of whom were listed with participating general practitioners. Patients - The Type 2 diabetic population alive and resident in the county on 1 January 1997. Results - In a population of 4438 Type 2 diabetics, 73% had a minimum of one annual HbA1c measurement in 1997. No HbA1c measurement was associated with a long history of diabetes, diet treatment or old age. Poor glycaemic regulation was found in 65% of the Type 2 diabetics in 1997. Poor glycaemic regulation was associated with tablet or insulin treatment, age under 70 years and long history of diabetes. The interpractice variation was huge. Conclusion - The quality of HbA1c monitoring of Type 2 diabetics needs to be improved. Possibilities for improvement seem to be present. [ABSTRACT FROM AUTHOR]

The article reflects on the use of qualitative studies in evaluating healthcare strategies and effect studies. It states advantages of qualitative studies over the traditionally used quantitative method. The author also cites instances where combination of the two methods is effectively applied in a study as well as situations where the combination results to discrepancies in data.

Talks about principles and practice of screening for disease. Criteria to be met before a screening strategy is implemented; Implications associated with screening for general practitioners; Evaluation on the different approaches to screening.