22 April 2008 Implementing CVD risk assessment in Primary Care Julia Hippisley-Cox Department of Health 22 nd April 2008.

Slides:

Advertisements

Similar presentations

Dr. David Lyon Clinical Governance Lead Halton PCT GP Affiliate NPDT.

Advertisements

10 Points to Remember for the Management of Overweight and Obesity in Adults Management of Overweight and Obesity in Adults Summary Prepared by Elizabeth.

Cardio-Metabolic Syndrome Guidelines on Education, Detection and Early Treatment Heval Mohamed Kelli, PGY-2 Emory Internal Medicine Residency no conflict.

Weekly data exports from GP systems into CDR-Intell (for GPs who wish to use this software) Practice identifies target population for 2009/10 LES (55,000.

CKD In Primary Care Dr Mohammed Javid.

CVD risk estimation and prevention: An overview of SIGN 97.

CVD prevention & management: a new approach for primary care Rod Jackson School of Population Health University of Auckland New Zealand.

1 Estimating vascular age SCORE Canada For example : Male, Age 53 Male, Age 53 Smoker Smoker Syst BP = 146mmHg Syst BP = 146mmHg T Chol/HDL-C ratio = 5.

Is low-dose Aspirin use associated with a reduced risk of colorectal cancer ? a QResearch primary care database analysis Prof Richard Logan, Dr Yana Vinogradova,

Absolute cardiovascular disease risk Assessment and Early Intervention Dr Michael Tam Lecturer in Primary Care

Cohort Studies Hanna E. Bloomfield, MD, MPH Professor of Medicine Associate Chief of Staff, Research Minneapolis VA Medical Center.

February is American Heart Month LEARN ABOUT YOUR RISKS FOR HEART DISEASE AND STROKE AND STAY "HEART HEALTHY" FOR YOURSELF AND YOUR LOVED ONES. Presented.

Instructor - Cindy Quisenberry.  Is a number calculated from a person’s weight and height. BMI is a fairly reliable indicator of body fatness for most.

What is Body Mass Index (BMI) What is Body Mass Index (BMI)

Investigating the effectiveness of a Stage IV Cardiac Rehabilitation Programme A collaborative project between Heartbeat NW and UCLan.

Height Weight Chart Is BMI Reliable as a measure of Obesity By Michael Goodman -

Welcome to FitKidney Health Program

Addenbrooke’s Hospital Rosie Hospital Caring for Patients in their Last Days of Life Dr Douglas Maslin (ACF CMT1) and Dr Kate Kiln (CMT2) Supervisor: Dr.

Population Impact Measures (PIM)

Professor Julia Hippisley-Cox University of Nottingham.

Tt HRB Centre for Health and Diet Research The burden of hypertension Ivan J Perry, Dept. of Epidemiology and Public Health, University College Cork. Institute.

EHRS as a Tool to Improve BP Control 1.Brief history of OQIUN, CCI. Began 1999 using data cards. Started working with multiple practice sites using different.

... a KAISER PERMANENTE Innovation IndiGO: Tailoring Guidelines to Individuals David M Eddy MD PhD Founder and Chief Medical Officer Emeritus Archimedes.

Deep Dive Case Study Healthy Heart Check (NHS Health Check)

SUPPORTING PRIMARY CARE TO ACHIEVE TARGETS. What targets? 1.9 care processes 2.3 health targets (HbA1c, blood pressure, cholesterol) AND IMPORTANTLY Quality.

Risk estimation and the prevention of cardiovascular disease SIGN 97.

Projecting Future Mortality Using Information on Health Behaviors David M. Cutler, Edward L. Glaeser, and Allison B. Rosen.

British Journal of Healthcare Assistants The HCAs Role in Diabetes Management in Primary Care Linda Goldie Clinical Director Primary Care Training Centre.

Improving the Quality of Physical Health Checks

Improving the Quality of Physical Health Checks Kate Dale, Mental/Physical Health Lead BDCT.

Quality improvement in non glycaemic targets in diabetic patients at Central Australian Aboriginal Congress John Boffa Public Health Medical Officer.

1 NHLBI/NEI National Institutes of Health NHLBI/NEI National Institutes of Health.

Tina Huang.  Aimed at people aged 40 – 74  Risk assessment and management programme to prevent or delay the onset of diabetes, heart and kidney disease.

The 2009 New Zealand Cardiovascular Guidelines Handbook What’s new?

Risk of colorectal cancer in patients taking statins and NSAIDS Dr Yana Vinogradova, Prof Julia Hippisley-Cox, Dr Carol Coupland and Prof Richard Logan.

GPs’ decisions on drug therapies by number needed to treat Peder A. Halvorsen University of Tromsø, Norway Torbjørn Wisløff Ivar Sønbø Kristiansen University.

Exposure to cyclo-oxygenase-2 inhibitors and risk of cancer: nested case-control studies IAE world Congress Epidemiology 2011 Edinburgh Yana Vinogradova,

Studying mortality trends: The IMPACT CHD Policy Model

Pai JK et al. N Engl J Med 2004; 351: Relative CHD risk by increasing baseline CRP plasma levels,* relative to CRP

The benefits of Community Pharmacy delivering Vascular Risk Assessments.

Supporting Vascular Risk Assessment: QDScore Julia Hippisley-Cox 15 th April 2010.

Cardiac MCN April 2007 Tackling Health Inequalities: Keep Well Programme.

Nottingham City PCT1 Quality improvement to ensure health gain (and Health Inequalities reductions) an example: commissioning cardiovascular risk management.

+ NHS Health Check Programme Priscilla Wong GPST2.

NHS Health Check Training Lauren Seamons – Norfolk LPC October/November 2015.

Project supported by A Package of Innovation for Managing kidney disease in primary care Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2.

Using QOF and Service Specifications to meet HI Needs Rachel Foskett-Tharby.

Clinical Health Indicator Improvements and Hospital Usage Report Health Integration Project December 2013 Matthew Rich Matthew Rich – Health Integration.

Monitoring Physical Health Stephen R. Marder, M.D. Professor, Semel Institute for Neuroscience and Human Behavior at UCLA Director, VA VISN 22 Mental Illness.

THE BASICS Across the triborough of London 3 years contract with possible 1 year extension Based at Galena Road with existing Kick It service Some joint.

The Management of People at High Risk of CVD Dr Richard Healicon Mel Varvel NHS Improvement Jan Procter-King CVD Nurse & National Trainer.

Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC Yazid NJ Al Hamarneh, BPharm, PhD Charlotte Jones, MD, PhD, FRCP(C) Brenda Hemmelgarn, MD, PhD, FRCP(C)

PUTTING PREVENTION FIRST Vascular Checks/ NHS Health Checks.

NHS Health Checks Annual review of >20% risk patients Dr Stephen Liversedge – Clinical Lead for Primary care NHS Bolton CCG.

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: The Effectiveness of Pharmacist Interventions on.

Rosemarie Bernabe, PhD Julius Center for Health Sciences and Primary Care Patient representatives’ contributions to the benefit-risk assessment tasks of.

Diabetes Care Planning Interim Results

Copyright © 2015 by the American Osteopathic Association.

Diabetes Clinical Audit- July/Aug 2014

QScores: Supporting Vascular Risk Assesessment

Physical Health and People with a Severe Mental Illness

Delivery of the NHS Health Check by health trainers can improve conversion into uptake of lifestyle service Dr Ifeoma Onyia Public Health Consultant Halton.

An assessment of correlation between ethnicity and modifiable risk factors in the context of primary prevention of cardiovascular disease Patel PA2,

Cardiometabolic Health Check

Interventions to Improve Adherence

by Peter Ueda, Thomas Wai-Chun Lung, Philip Clarke, and Goodarz Danaei

How to Teach it?.

by Peter Ueda, Thomas Wai-Chun Lung, Philip Clarke, and Goodarz Danaei

Risk Factors for CHD L.O – Describe the global distribution of CHD and the risk factors associated with it.

NICE resources for STPs: MECC

Presentation transcript:

22 April 2008 Implementing CVD risk assessment in Primary Care Julia Hippisley-Cox Department of Health 22 nd April 2008

QRisk © 2008 All rights reserved Objectives Thoughts on presenting risk to patients Practical aspects of implementing CVD risk assessment in Primary Care Patient ‘e’ record access - current realities & future vision

22 nd April 2008 QRisk © 2008 All rights reserved Presenting risk to patients Patients need to know What is my risk of developing CVD? What can I do to reduce my risk? How effective will this be?

22 nd April 2008 QRisk © 2008 All rights reserved How best to present risk? Keep it clear & simple Pictures say a thousand words Absolute AND relative risk Present in context of every day things Give appropriate perspective “ The bad news is your risk has doubled --- the good news is its gone from one in a million to two in a million…..”

22 nd April 2008 QRisk © 2008 All rights reserved What is my risk? CVD risk of 20% over 10 years Take a 100 people like you, and 20 will develop CVD over the next 10 years (and 80 people wont!) Easier to understand than “one in five”

22 nd April 2008 QRisk © 2008 All rights reserved How do I compare? Your risk is three times that of an average risk for a person of your age/sex

22 nd April 2008 QRisk © 2008 All rights reserved Effect of interventions For smokers: what if stop smoking For overweight: what if loose weight High lipids: what if take statins BP treatment: what if BP treated If you do all of these But modelling the ‘what if’s” complex

22 nd April 2008 QRisk © 2008 All rights reserved CVD Risk Assessment Tool Kit On line web calculator for patients for self assessment Downloadable risk calculator for docs Risk stratification tools for primary care MUST be v simple to use, quick, accessible and make best use existing data MUST get the RIGHT people and not widen health inequalities

22 nd April 2008 QRisk © 2008 All rights reserved Risk stratification tool kit –key goals Utilities for all general practices to to auto-generate a risk recall register based on ‘estimated risk’ Calculate an `actual risk’ within the consultation Present risk and discuss effect of interventions to patients

22 nd April 2008 QRisk © 2008 All rights reserved Risk stratification/recall list Computer search to calculate score for all patients Uses estimated values for SBP, BMI, cholesterol/hdl ratio where missing Rank all patients and highlight which patients need what interventions

22 nd April 2008 QRisk © 2008 All rights reserved

22 nd April 2008 QRisk © 2008 All rights reserved Clinical calculation actual risk Utility to calculate ‘actual’ risk in consultation and present it back to patients Explain likely effectiveness of interventions

22 nd April 2008 QRisk © 2008 All rights reserved

22 nd April 2008 QRisk © 2008 All rights reserved

22 nd April 2008 QRisk © 2008 All rights reserved

22 nd April 2008 QRisk © 2008 All rights reserved Personalised plan & printable prescriptions ItemMy risksMy goalsMy actions 10 year risk of CVD27 % (ie 27 out of 100) Reduce this by halfMore exercise See GP 2 months Smoking20 /dayStop smokingAttend new leaf Blood pressure155/87mmHgLower it < 140/90mmHg Take tablets Body mass index37 kg/m2Ideal <26Loose weight attend weight group Cholesterol6.2 mmols/lIdeal <5mmols/lLow fat diet take statins if no better eGFR (kidney test)58>89Need further tests Random Glucose7.3mmols/l<6mmols/lNeed further tests

22 nd April 2008 QRisk © 2008 All rights reserved Quote from a GP in London “Obviously, the knowing the absolute risk reduction from treatment is essential for a patient to make an informed decision as to whether or not to accept treatment. We are currently doing them a great disservice, by not providing them with better information”.