{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:24:44Z","timestamp":1785234284232,"version":"3.55.0"},"reference-count":40,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Better Care Victoria","award":["no award\/grant number"],"award-info":[{"award-number":["no award\/grant number"]}]},{"name":"Macedon Ranges and North West Melbourne Medicare Local","award":["no award\/grant number"],"award-info":[{"award-number":["no award\/grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Fam Med Com Health"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the capacity of general practice (GP) electronic medical record (EMR) data to assess risk factor detection, disease diagnostic testing, diagnosis, monitoring and pharmacotherapy for the interrelated chronic vascular diseases\u2014chronic kidney disease (CKD), type 2 diabetes (T2D) and cardiovascular disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional analysis of data extracted on a single date for each practice between 12 April 2017 and 18 April 2017 incorporating data from any time on or before data extraction, using baseline data from the Chronic Disease early detection and Improved Management in PrimAry Care ProjecT. Deidentified data were extracted from GP EMRs using the Pen Computer Systems Clinical Audit Tool and descriptive statistics used to describe the study population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Eight GPs in Victoria, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients were \u226518 years and attended GP \u22653 times within 24 months. 37\u2009946 patients were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Risk factor and disease testing\/monitoring\/treatment were assessed as per Australian guidelines (or US guidelines if none available), with guidelines simplified due to limitations in data availability where required. Risk factor assessment in those requiring it: 30% of patients had body mass index and 46% blood pressure within guideline recommended timeframes. Diagnostic testing in at-risk population: 17% had diagnostic testing as per recommendations for CKD and 37% for T2D. Possible undiagnosed disease: Pathology tests indicating possible disease with no diagnosis already coded were present in 6.7% for CKD, 1.6% for T2D and 0.33% familial hypercholesterolaemia. Overall prevalence: Coded diagnoses were recorded in 3.8% for CKD, 6.6% for T2D, 4.2% for ischaemic heart disease, 1% for heart failure, 1.7% for ischaemic stroke, 0.46% for peripheral vascular disease, 0.06% for familial hypercholesterolaemia and 2% for atrial fibrillation. Pharmaceutical prescriptions: the proportion of patients prescribed guideline-recommended medications ranged from 44% (beta blockers for patients with ischaemic heart disease) to 78% (antiplatelets or anticoagulants for patients with ischaemic stroke).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using GP EMR data, this study identified recorded diagnoses of chronic vascular diseases generally similar to, or higher than, reported national prevalence. It suggested low levels of extractable documented risk factor assessments, diagnostic testing in those at risk and prescription of guideline-recommended pharmacotherapy for some conditions. These baseline data highlight the utility of GP EMR data for potential use in epidemiological studies and by individual practices to guide targeted quality improvement. It also highlighted some of the challenges of using GP EMR data.<\/jats:p><\/jats:sec>","DOI":"10.1136\/fmch-2021-001006","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T16:40:36Z","timestamp":1645116036000},"page":"e001006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Using electronic medical record data to assess chronic kidney disease, type 2 diabetes and cardiovascular disease testing, recognition and management as documented in Australian general practice: a cross-sectional analysis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1266-4731","authenticated-orcid":false,"given":"Julia L","family":"Jones","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie G","family":"Lumsden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Simons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anis","family":"Ta'eed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian P","family":"de Courten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tissa","family":"Wijeratne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Cox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J A","family":"Neil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo-Anne","family":"Manski-Nankervis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Shane","family":"Hamblin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward D","family":"Janus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig L","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"2022021708401405000_10.1.e001006.1","unstructured":"Australian Institute of Health and Welfare . Diabetes and chronic kidney disease as risks for other diseases: Australian burden of disease study 2011 cat. No. BOD 9. Canberra, 2016."},{"key":"2022021708401405000_10.1.e001006.2","unstructured":"Australian Institute of Health and Welfare . Cardiovascular disease, diabetes and chronic kidney disease\u2014 Australian facts: prevalence and incidence, 2014. Canberra. Available: https:\/\/www.aihw.gov.au\/reports\/heart-stroke-vascular-diseases\/cardiovascular-diabetes-chronic-kidney-prevalence\/summary"},{"key":"2022021708401405000_10.1.e001006.3","unstructured":"Australian Institute of Health and Welfare . Cardiovascular disease, diabetes and chronic kidney disease\u2014 Australian facts: mortality, 2014. Canberra. Available: https:\/\/www.aihw.gov.au\/reports\/heart-stroke-vascular-diseases\/cardiovascular-diabetes-chronic-kidney-mortality\/summary"},{"key":"2022021708401405000_10.1.e001006.4","unstructured":"Australian Institute of Health and Welfare . Australia\u2019s health 2018. Australia\u2019s health series no. 16 AUS 221, 2018. Canberra. Available: https:\/\/www.aihw.gov.au\/reports\/australias-health\/australias-health-2018\/contents\/overview"},{"key":"2022021708401405000_10.1.e001006.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosissup.2011.06.001"},{"key":"2022021708401405000_10.1.e001006.6","doi-asserted-by":"crossref","first-page":"186","DOI":"10.18773\/austprescr.2019.067","article-title":"Atrial fibrillation: an update on management","volume":"42","author":"McCallum","year":"2019","journal-title":"Aust Prescr"},{"key":"2022021708401405000_10.1.e001006.7","unstructured":"Australian Institute of Health and Welfare . Cardiovascular disease, diabetes and chronic kidney disease\u2014 Australian facts: Aboriginal and Torres Strait Islander people, 2015. Canberra. Available: https:\/\/www.aihw.gov.au\/reports\/heart-stroke-vascular-disease\/cardiovascular-diabetes-chronic-kidney-indigenous\/summary"},{"key":"2022021708401405000_10.1.e001006.8","unstructured":"Kidney Health Australia . Chronic kidney disease (CKD) management in general practic. 3rd edn. Melbourne, 2015."},{"key":"2022021708401405000_10.1.e001006.9","unstructured":"Royal Australian College of general practitioners . Guidelines for preventive activities in general practice. 9th edn. Melbourne, 2018."},{"key":"2022021708401405000_10.1.e001006.10","doi-asserted-by":"crossref","first-page":"254","DOI":"10.5694\/j.1326-5377.2010.tb03502.x","article-title":"Cardiovascular risk perception and evidence--practice gaps in Australian general practice (the AusHEART study)","volume":"192","author":"Heeley","year":"2010","journal-title":"Med J Aust"},{"key":"2022021708401405000_10.1.e001006.11","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr599"},{"key":"2022021708401405000_10.1.e001006.12","unstructured":"Shaw J , Tanamas S . Diabetes: the silent pandemic and its impact on Australia. baker IDI heart and diabetes Institute, 2012."},{"key":"2022021708401405000_10.1.e001006.13","doi-asserted-by":"crossref","first-page":"289","DOI":"10.31128\/AJGP-11-17-4413","article-title":"How common is multiple general practice attendance in Australia?","volume":"47","author":"Wright","year":"2018","journal-title":"Aust J Gen Pract"},{"key":"2022021708401405000_10.1.e001006.14","unstructured":"Britt H , Miller G , Henderson J . General practice activity in Australia 2014-15. general practice series. Vol 38, 2015."},{"key":"2022021708401405000_10.1.e001006.15","first-page":"121","article-title":"eMAP:CKD: electronic diagnosis and management assistance to primary care in chronic kidney disease","volume":"33","author":"Pefanis","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"2022021708401405000_10.1.e001006.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2016.09.012"},{"key":"2022021708401405000_10.1.e001006.17","unstructured":"NPS MedicineWise . General practice insights report July 2017-June 2018. Sydney, 2019."},{"key":"2022021708401405000_10.1.e001006.18","unstructured":"Royal Australian College of general practitioners and diabetes Australia . General practice management of type 2 diabetes \u2013 2014\u201315. Melbourne, 2014."},{"key":"2022021708401405000_10.1.e001006.19","unstructured":"National heart Foundation of Australia and the cardiac Society of Australia and New Zealand . Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. Melbourne, 2012."},{"key":"2022021708401405000_10.1.e001006.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.06.1042"},{"key":"2022021708401405000_10.1.e001006.21","unstructured":"National Stroke Foundation . Clinical guidelines for stroke management. Melbourne, 2010."},{"key":"2022021708401405000_10.1.e001006.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.008"},{"key":"2022021708401405000_10.1.e001006.23","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"2022021708401405000_10.1.e001006.24","unstructured":"Australian Bureau of Statistics . IRSD interactive MAP Canberra, 2018. Available: https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/Lookup\/by%20Subject\/2033.0.55.001~2016~Main%20Features~IRSD%20Interactive%20Map~15"},{"key":"2022021708401405000_10.1.e001006.25","unstructured":"Australian Bureau of Statistics . Estimates of Aboriginal and Torrest Strait Islander Australians, June 2016, 2018. Canberra. Available: https:\/\/www.abs.gov.au\/statistics\/people\/aboriginal-and-torres-strait-islander-peoples\/estimates-aboriginal-and-torres-strait-islander-australians\/latest-release#:~:text=The%20final%20estimated%20resident%20Aboriginal,of%20the%20total%20Australian%20population."},{"key":"2022021708401405000_10.1.e001006.26","unstructured":"Australian Bureau of Statistics . Hypertension and measured high blood pressure - National Health Survey: First results, 2014-15, 2015. Canberra. Available: https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/Lookup\/by%20Subject\/4364.0.55.001~2014-15~Main%20Features~Hypertension%20and%20measured%20high%20blood%20pressure~14"},{"key":"2022021708401405000_10.1.e001006.27","unstructured":"Australian Bureau of Statistics . 4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13, 2013. Canberra. Available: https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/4363.0.55.001"},{"key":"2022021708401405000_10.1.e001006.28","unstructured":"Australian Bureau of Statistics . Australian health survey: biomedical results for chronic diseases, 2011-12, 2013. Canberra. Available: https:\/\/www.abs.gov.au\/statistics\/health\/health-conditions-and-risks\/australian-health-survey-biomedical-results-chronic-diseases\/latest-release#:~:text=In%202011%E2%80%9312%2C%2011.0%25,have%20abnormal%20levels%20of%20GGT."},{"key":"2022021708401405000_10.1.e001006.29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4298"},{"key":"2022021708401405000_10.1.e001006.30","doi-asserted-by":"crossref","unstructured":"Langham RG . Chronic kidney disease controversy: how expanding definitions are unnecessarily labelling many people as diseased, 2013. Available: https:\/\/www.bmj.com\/content\/347\/bmj.f4298\/rr\/658325 [Accessed Jan 28, 2022].","DOI":"10.1136\/bmj.f4298"},{"key":"2022021708401405000_10.1.e001006.31","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-016-0208-4"},{"key":"2022021708401405000_10.1.e001006.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.03.027"},{"key":"2022021708401405000_10.1.e001006.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.12.013"},{"key":"2022021708401405000_10.1.e001006.34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2002.tb00677.x"},{"key":"2022021708401405000_10.1.e001006.35","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.hlc.2018.04.292","article-title":"Prevalence and outcomes of undiagnosed peripheral arterial disease among high risk patients in Australia: an Australian reach Sub-Study","volume":"28","author":"Si","year":"2019","journal-title":"Heart Lung Circ"},{"key":"2022021708401405000_10.1.e001006.36","unstructured":"Australian Institute of Health and Welfare . Indicators of socioeconomic inequalities in cardiovascular disease, diabetes and chronic kidney disease cat No. CDK 12, 2019. Canberra. Available: https:\/\/www.aihw.gov.au\/reports\/social-determinants\/indicators-socioeconomic-inequalities\/summary"},{"key":"2022021708401405000_10.1.e001006.37","unstructured":"National Vascular Disease Prevention Alliance . Guidelines for the management of absolute cardiovascular risk, 2012. https:\/\/www.heartfoundation.org.au\/getmedia\/4342a70f-4487-496e-bbb0-dae33a47fcb2\/Absolute-CVD-Risk-Full-Guidelines_2.pdf"},{"key":"2022021708401405000_10.1.e001006.38","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare4030036","article-title":"Barriers and strategies in guideline Implementation-A scoping review","volume":"4","author":"Fischer","year":"2016","journal-title":"Healthcare"},{"key":"2022021708401405000_10.1.e001006.39","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-016-1748-0","article-title":"Current and projected burden of heart failure in the Australian adult population: a substantive but still ill-defined major health issue","volume":"16","author":"Chan","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"2022021708401405000_10.1.e001006.40","unstructured":"Gordon J , Miller G , Britt H . Reality check - reliable national data from general practice electronic health records. Deeble Institute, 2016."}],"container-title":["Family Medicine and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fmch-2021-001006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T16:40:54Z","timestamp":1645116054000},"score":1,"resource":{"primary":{"URL":"https:\/\/fmch.bmj.com\/lookup\/doi\/10.1136\/fmch-2021-001006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,2,17]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/fmch-2021-001006"],"URL":"https:\/\/doi.org\/10.1136\/fmch-2021-001006","relation":{},"ISSN":["2305-6983","2009-8774"],"issn-type":[{"value":"2305-6983","type":"print"},{"value":"2009-8774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]}}}