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Fabiani L, Scatigna M, Panopoulou K, Sabatini A, Sessa E, Donato F, Marchi M, Nardi R, Niccolai C, Samani F, Ventriglia
G. Health Search: istituto di ricerca della societą italiana di medicina generale: la realizzazione di un database
per la ricerca in medicina generale.
Epidemiol & Prev. 2004; 28: 156-162
ABSTRACT. OBJECTIVE: To describe a database used in general practice by analysing the characteristics of the physicians
providing the data and the completeness of the data recording on the basis of the indicators of interest (smoking habits,
weight, height, and the prevalence of hypertension). DESIGN: Descriptive study and multiple linear regression analysis
of the relationships between structural variables and outcomes. SETTING: General practitioners (GPs) belonging to the
Italian Society of General Medicine (SIMG), and enrolled in Health Search (HS). POPULATION: Six hundred and ninety-
five voluntarily enrolled GPs and their patients. PRINCIPAL OUTCOMES: Descriptive statistics (mean and median values,
standard deviation, frequencies) concerning the general characteristics of the GPs, the ways in which they connect to
the network and their use of the clinical data management software, and epidemiological measures concerning the
prevalence of hypertension among their patients, and the recording of weight, height and tobacco smoking habits.
RESULTS: The geographic distribution of the GPs is homogeneous: 317 in Northern Italy (12.52 physicians per 10(6)
patients), 134 in Central Italy (12.30 physicians per 10(6) patients) and 244 in Southern Italy and the Islands (11.89
physicians per 10(6) patients). Five hundred and ninety-five (85.6%) are males; their mean age is 46.7 years (SD +/-
3.8); the mean number of patients per physician is 1128; 69% have at least one post-graduate specialisation; 49%
practise alone; and they work for a mean of 30 hours per week (SD +/- 13). Five hundred and fifty-three GPs were
actually connected to the network as of January 2003. The data relating to the years 2000-2001 show an increase in
the number of connected physicians (34 in 2000 and 261 in 2001) and in the number of connections (a median of 12
in 2000 and 17 in 2001). The GPs contact more than 80% of their patients every year. The frequency of the recording
of data concerning smoking habits, weight and height increases in proportion with the frequency of connections. The
prevalence of hypertension among the patients included in the survey is 5.4%. Multiple regression analysis showed that
the variability in the prevalence of hypertension was not influenced by the frequency of PC use but by the different
structure of the age classes of the patients. CONCLUSIONS: This study of the variables relating to GPs, their clinical
practices, and their use of computerised records (examined by means of the chosen indicators) shows that the regular
and complete recording of the principal data of health interest is feasible insofar as it is not biased by the characteristics
of the GPs, and advantageous. The construction of the database therefore represents a first step towards the initiation
of routine research into general practice in Italy.
Filippi A, Gensini G, Bignamini AA, Sabatini A, Mazzaglia G, Cricelli C. Management of patients with suspected
angina, but without known myocardial infarction: a cross-sectional survey. Br J Gen Pract 2004; 54: 429-33
ABSTRACT. BACKGROUND: Although several studies describing the diagnostic and therapeutic management of
patients with myocardial infarction (MI) by general practitioners have recently been published, little information exists
about patients with angina without MI. AIM: To describe the management of patients with angina without known
MI in general practice. DESIGN: A cross-sectional survey. SETTING: Italian general practitioners providing data to the
Health Search Database. METHOD: Prevalent cases of angina, using the prescription of nitrates as a `proxy' for disease
status, in patients without known MI were selected from the Health Search Database. Data on patient demographics,
clinical information, established therapies and cardiology visits were collected. A binomial logistic regression analysis
was performed to test which variable made prescription more or less likely. RESULTS: There were 10 455 patients with
angina. Blood pressure readings were available for 73.8% of patients; in this group 58.9% had inadequate (> or =
140/90 mmHg) blood pressure control. Total cholesterol was recorded in 61.6% of cases (mean value = 5.5 mmol/L).
Antiplatelet or oral anticoagulant agents were used by 67.8% of the patients, while 24.1% of patients received lipid-
lowering agents, 61% received ACE-inhibitors or angiotensin-II receptor antagonists, and 25.2% received beta-blockers.
CONCLUSIONS: In patients treated with nitrates the monitoring of modifiable risk factors and the use of preventive
drugs is lower than expected. New strategies aimed at improving secondary cardiovascular prevention among these
easily identifiable high-risk subjects are needed.
Filippi A, Buda S, Brignoli O, Cricelli C, Degli Esposti E. Global cardiovascular risk evaluation in italy: a cross
sectional survey in general practice.
It Heart J. 2004; 5: 223-7
ABSTRACT. BACKGROUND: The aim of our work was to evaluate, in a general practice setting, the attitude of general
practitioners in determining the individual coronary risk. METHODS: The coronary risk was determined among patients
aged 30 to 74 years using the following parameters: gender, age, smoking habits, diagnosis of diabetes mellitus,
systolic blood pressure, and total cholesterol. We evaluated the records of 446,331 subjects collected by 481 general
practitioners working throughout Italy. RESULTS: Except for age, gender and diabetes mellitus, risk factors were largely
under-recorded: blood pressure in 37.0% of the total patients, total cholesterol in 34.3%, smoking habits in 21.9%.