1. Cardiovascular Disease Prevention and Treatment in a Family Medicine Clerkship
Bonnie T. Jortberg, MS, RD, CDE
David Gaspar, MD
Cynthia Villanueva, MS
Department of Family Medicine
University of Colorado at Denver and Health Sciences Center

2. Cardiovascular Disease Prevention: Why Teach this in Medical School?
Approximately 120 million Americans have one or more chronic diseases
This accounts for 70-80%of health care costs
Epidemic of obesity and type 2 diabetes
2003 Association of American Medical Colleges survey of medical students reported only 46% believed that “appropriate time” had been devoted to nutrition instruction.

3. Obesity Trends* Among U.S. Adults BRFSS, 1990, 1995, 2005
(*BMI 30, or about 30 lbs overweight for 5’4” person)
1990
1995
2005
No Data <10% %–14% %–19% %–24% %–29% ≥30%

4. CVD Curriculum
Colorado ranks 1st for the lowest rate of CVD, but CVD still accounts for 32% of all deaths of Colorado residents
Colorado CVD rates higher in rural areas: our FM Clerkship is a rural rotation
Received grant funds for 3 years from the Colorado Department of Public Health and Environment to implement a CVD curriculum in our FM Clinical Training Block

5. CVD Grant Objectives
Objective #1: Provide education and outreach programs to rural Colorado physician-teachers (preceptors) on CVD evidence-based guidelines:
Hold ½ day workshops in rural Colorado for our preceptors (interactive format, CME credit)
Content:
CVD “Clinical Pearls” (medications, lifestyle modification, new research)
CVD/Obesity Guidelines

6. CVD Grant Objectives
Objective #2: Implement a CVD prevention & early detection curriculum into the FM Clinical Training Block:
CTB Orientation:
Small group discussion of CVD case study
Students need to complete the CHD Risk Score card and develop tx plan for case study patient
Step counters
Patient Follow-up postcards

7. CVD Grant Objectives
Objective #3: Translate CVD curriculum materials into Spanish and implement in CTB
Materials translated
Will be implementing and evaluating materials this year

8. Evaluation Objective #1: Pre/post workshop questionnaire
Results from 2 workshops:
Overall evaluation of workshops = 4.6 (5.0 likert scale)
75% of participants state that they intend to change their practice habits as a result of attending the workshop

9. Evaluation Objective #2: Pre/post CTB online questionnaire
Completion of 5 CHD Risk Score Cards
Patient Follow-up Postcards
Standardized Patient Testing

10. Evaluation (Pre/Post Questionnaire)
Pre-CTB (N=122)
Post-CTB (N=109)
Have you ever assessed CVD risk in a patient?
Yes = 50%
No = 50%
Yes = 93%
No = 6%
Lowering LDL Cholesterol should be the primary target of CVD therapy?
True = 52%
False = 48%
True = 74%
False = 26%

11. Evaluation (Pre/Post Questionnaire)
Pre-CTB
(N = 122)
Post-CTB
(N = 109)
Do you believe that you can influence patients to stop smoking?
Yes = 50%
No = 50%
Yes = 40%
Sometimes = 49%
No = 11%
Advise pt to quit smoking
Yes = 43%
Sometimes = 54%
No = 3%
Yes = 68%
Sometimes = 32%
No = 0%

12. Evaluation (Pre/Post Questionnaire)
Pre-CTB
(N = 122)
Post-CTB
(N = 109)
Have you referred pts to Quitline/Quitnet
Yes = 11%
Sometimes = 32%
No = 57%
Yes = 40%
Sometimes = 48%
No = 12%
Rating of use of CHD Score Card with Pt
N/A
Excellent = 23%
Good = 43%
Fair = 24%
Poor = 8%

13. Contact Information
Bonnie Jortberg
Thank you!