Overview of the CVD Risk Reduction Demonstration Project Kelly Acton, MD, MPH, FACP IHS Division of Diabetes Treatment & Prevention

The CVD Risk Reduction Demonstration Project We know “what” but we don’t know “how”

The CVD Risk Reduction Demonstration Project  Core elements – “what”  Development of intensive intervention– “how”  Collaborative process  Standards of Care  Case Management

The CVD Risk Reduction Demonstration Project  8 Core elements - Intensive Intervention Identify eligible individuals with Diabetes Recruit individuals with diabetes to participate Initial physical exam and baseline measures Case Management approach to clinic visits

The CVD Risk Reduction Demonstration Project  8 Core elements – Intensive Intervention Treat CVD risk factors to recommended target levels Education on diabetes and CVD risk reduction – group or individual Gather data on required evaluation measures Target number of participants per year = 50

Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics A1C, % Mean A1C, *p< comparing mean HbA1 levels in FY94 and Y03 year

Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics A1C % Glycemic control, *p< comparing mean HbA1 levels in FY94 and Y03 year

Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics BP, mm Hg Mean Systolic & Diastolic BPs, year

IHS Diabetes Care & Outcomes Audit Source: IHS National Diabetes Program Statistics Mean Lipid Values mg/dl year

The CVD Risk Reduction Demonstration Project  Less intensive intervention Community activities for people at risk for diabetes and cardiovascular disease and their families Focus on diabetes and cardiovascular disease risk reduction Tailor to community needs Evaluate activities

The CVD Risk Reduction Demonstration Project  Collaborative process  New way of doing business  Work outside our comfort levels

The CVD Risk Reduction Demonstration Project  Homework: review IHS Standards of Care for Diabetes Your recent (3-5 year) audit results NHLBI Curriculum – “Honoring the Gift of Heart Health”