Chest pain is a frequent reason for seeking medical attention. In primary care medicine, ischaemic heart disease is the underlying mechanism in 8 to 16% of these patients.
1-3 To support general practitioners (GPs) in their approach to patients with stable chest pain syndromes, the Dutch Association of General Practitioners or (in Dutch) the Nederlands Huisartsen Genootschap (NHG) has published an evidence-based guideline on angina pectoris (AP).
4 However, guidelines only have limited impact on (changing) a physician’s routine practice.
5,6 Studies in other countries have shown that the medical care of patients with stable angina is often suboptimal
7-11 and it seems legitimate to assume that the situation is not different in the Netherlands. A Dutch study, for example, showed that only 51% of patients with AP diagnosed by GPs were prescribed aspirin.
12 Yet, as far as we know, adherence to the NHG guideline ‘Stable Angina Pectoris’ has never been more extensively studied. We therefore conducted a retrospective survey in a selected group of patients, i.e. those who were referred to our outpatient department for the evaluation of stable chest pain symptoms. …