Adherence to a guideline on cardiovascular prevention: A comparison between general practitioners and practice nurses
Abstract
Background Patient non-compliance with prescribed treatment is an important factor in the lack of success in cardiovascular prevention. Another important cause is non-adherence of caregivers to the guidelines. It is not known how doctors and nurses differ in the application of guidelines. Patient compliance to treatment may vary according to the type of caregiver.Objective To compare adherence to cardiovascular prevention delivered by practice nurses and by general practitioners.Setting Six primary health care centres in the Netherlands (25 general practitioners, six practice nurses).Methods 701 high risk patients were included in a randomised trial. Half of the patients received nurse-delivered care and half received care by general practitioners. For 91% of the patients treatment concerned secondary prevention. The Dutch guideline on cardiovascular prevention was used as protocol. A structured self-administered questionnaire was sent by post to patients. Data were extracted from the practice database and the questionnaire.Results Intervention was received by 77% of respondents who visited the practice nurse compared to 57% from the general practitioner group (OR = 2.56, p < 0.01). More lifestyle intervention was given by the practice nurse; 46% of patients received at least one lifestyle intervention (weight, diet, exercise, and smoking) compared to 13% in general practitioner group (OR = 3.24, p < 0.001). In addition, after one year more patients from the practice nurse group used cardiovascular drugs (OR = 1.9, p = 0.03). Nurses inquired more frequently about patient compliance to medical treatment (OR = 2.1, p < 0.01). Regarding patient compliance, no statistical difference between study groups in this trial was found.Conclusion Practice nurses adhered better to the Dutch guideline on cardiovascular prevention than general practitioners did. Lifestyle intervention advice was more frequently given by practice nurses. Improvement of cardiovascular prevention is still necessary. Both caregivers should inquire about patient adherence on a regular basis.
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Nurse practitioners have been reported to be more likely to follow guidelines and document care.
“Nurse practitioners have been reported to be more likely to follow guidelines and document care [37, 38].”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [37]
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- Authors
- Voogdt-Pruis, H. R., Van Ree, J. W., Gorgels, A. P. M., & Beusmans, G. H. M. I.
- Affiliations
- Maastricht University Medical Centre (NL)
- Corresponding author
- Voogdt-Pruis, Helene R.
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 48
- Issue
- 7
- Pages
- 798-807
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W1975552930
- Cited by
- 38
- References
- 63
- Citations by year
- 2026: 2 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 6 · 2013: 6 · 2012: 3
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- cardiovascular disease prevention, guideline adherence, practice nurses, general practitioners, secondary prevention, lifestyle intervention, cardiovascular drugs, high-risk patients, primary care, nursing care delivery
- MeSH terms
- Aged, Cardiovascular Diseases, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nurse-Patient Relations, Nurses, Primary Health Care, Surveys and Questionnaires, Guideline Adherence, General Practitioners
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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