Management of secondary risk factors and the effects of combination aspirin clopidogrel on platelet function in claudicants
This research study consisted of three parts. In the first part two surveys were conducted, one among General Practitioners (GPs) in Grampian Area of Scotland and the second among Consultant Vascular Surgeons throughout the United Kingdom and Ireland, which aimed to explore the attitudes towards management of secondary risk factors in patients with intermittent claudication. Postal questionnaires were used to determine how GPs and Consultant vascular surgeons screened for and controlled the major risk factors - cigarette smoking, hypertension, diabetes and hyperlipidaemia, whether and what anti-platelet treatment was prescribed, and the availability of facilities such as smoking cessation clinics and supervised exercise programmes for patients with intermittent claudication. The findings from the GP survey were compared with the responses to a questionnaire of patients with intermittent claudication referred to the Vascular Clinic, Aberdeen Royal Infirmary and to the results of blood investigations. The results of the two surveys showed that a significant proportion of both GPs and Consultant Vascular Surgeons do not abide by current recommendations on management of major secondary risk factors. This may be partly due to the lack of national guidelines and the paucity of local guidelines specifically on the management of secondary risk factors in intermittent claudication. The surveys have also identified serious deficiencies in the availability of supervised exercise and smoking cessation programmes for this group of patients. Only a very small minority of consultant vascular surgeons have access to a vascular physician. Furthermore a wide discrepancy was noted between the claims made by GPs.