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Case-Based Training for GPs Lowers Heart Disease Risks

Results in decreased mortality rates in patients with coronary heart disease

WEDNESDAY, May 11 (HealthDay News) -- Use of case-based training for general practitioners to implement evidence-based guidelines with intensified lipid-lowering recommendations is associated with a decrease in the 10-year mortality rates in patients with coronary heart disease (CHD), according to a study published in the May/June issue of the Annals of Family Medicine.

Anna Kiessling, M.D., Ph.D., from the Danderyd Hospital in Stockholm, Sweden, and colleagues investigated whether a case-based intervention in primary care improved long-term survival in 255 patients with CHD. Eighty-eight patients with CHD, treated by 54 general practitioners, were randomly assigned to usual care as a control or to an active intervention. All general practitioners were sent new evidence-based guidelines, with intensified lipid-lowering recommendations for CHD. Repeated case-based training was given to general practitioners in the intervention group during a two-year period. A total of 167 patients treated by specialists made up the internal specialist comparison group. Ten-year mortality rates were calculated for all the groups.

The investigators found that 22 percent of the patients in the intervention group had died at 10 years compared to 44 percent in the control group (hazard ratio, 0.45) due to significantly reduced cardiovascular mortality in the intervention group. The intervention group mortality rates of 22 percent were comparable to the specialist-treated group mortality rate of 23 percent.

"Our study's findings suggest that case-based training in the context of contemporary clinical practice is effective not only in decreasing hyperlipidemia among patients with CHD, but also in decreasing their mortality," the authors write.

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