Probe into the State of Treatment at Different Levels of HealthCare in Prague

Overview

By investigation in the surgery of a general practitioner and clinical department (hospital) theauthors assessed the state of secondary prevention of ischaemic heart disease (IHD) and howdyslipidaemia is influenced by medicamentous treatment. They analyzed the use of hypolipidaemicagents in 50 patients of the GP and another 50 patients in the hospital out-patientdepartment. From the whole group of 100 patients with IHD i.e. from both workplaces (anginapectoris and conditions after myocardial infarction) 60 (60%) took hypolipidaemic agents. Thefrequency of their prescription was significantly higher in hospital than in the surgery of theGP (40 vs. 20 subjects, p < 0.001). The patients with existing dyslipidaemia were treated withhypolipidaemics more frequently in hospital (21 of 27) than in the surgery of the GP (20 of 36,n.s.). Successful normalization of plasma lipids was however observed only in the hospitalout-patient department.The structure of treatment (statins vs. fibrates) differed significantly in the two workplaceswith an obvious predominance of statins in the clinical department (p < 0.001).As compared with major European and American studies we find that the standard of secondaryprevention in the Prague region is acceptable but as to selection of hypolipidaemic therapy westill lag behind advanced countries.

Key words:
secondary prevention - hypercholesterolaemia - hypolipidaemic agents.