Policies and practices for the assessment and management of risk factors for coronary heart disease preventionThe perspective of the general practitioner

Recent government policy in the United Kingdom has prescribed an important role for primary health care In the key priority area of coronary heart disease prevention. One of the recommendations was to explore ways of developing existing health promotion arrangements in primary care in response to the national strategy. We sought to identify what these existing arrangements were. Information was collected through a survey and in-depth interviews with a random sample of general practitioners (GPs) in England during 1991 and 1992. General practitioners' policies and practices in relation to risk factor assessment and management as well as the policies employed in health promotion clinics were examined. General practitioners' involvement was confined to opportunistic risk assessment and management in the consultation. However, there was little evidence of systematic opportunistic risk factor assessment as emphasis was placed primarily upon blood pressure and smoking. The majority of the general practices had well-person clinics, which were usually run by nurses. There was a greater likelihood of systematic tests and measurements and assessment of risk factors in well-person clinics than in the context of the normal GP consultation.