Promoting Cardiovascular Disease Risk Screening in Primary Care

Download or read book Promoting Cardiovascular Disease Risk Screening in Primary Care written by Andrew Decker and published by . This book was released on 2019 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Despite significant modern-day advances in healthcare, cardiovascular disease (CVD) remains the number one killer in the United States and throughout the world. Many who do not succumb to a heart attack or stroke are left debilitated, and likely to experience a future event. The financial burden of CVD is significant and on the rise. The numbers of procedures and invasive surgeries performed to manage advanced disease are staggering. Primary care providers are well-positioned to initiate risk-reduction therapies, but many times fail to do so. Discussions about risk factors and treatment options are far-too often neglected. Better identification and management of at-risk individuals is needed in the primary care setting. Strategies should target patients and providers. EBP Framework: Stetler's Model od Evidence-Based Practice, Lewin's Change Theory, and Orem's Self-Care Deficit Theory guided the implementation of the American College of Cardiology's ASCVD Risk Estimator Plus (ASCVDREP) in a primary care setting. The literature supports a global risk assessment strategy that considers the synergistic effects of all risk factors. The provision of risk scores enhances risk perceptions and encourages clinician-patient discussions. These discussions serve to promote medication intervention, boost patient engagement, increase medication adherence, and benefit the patient-clinician relationship. Methods: A variety of strategies were devised to encourage patients and clinicians to utilize the ASCVDREP. A luncheon and presentation were prepared, along with posters, flyers, and risk assessment forms. Stakeholders and change agents were targeted to promote participation and sustained change. Readiness for change among clinicians was a concern addressed by the recruitment and involvement of all staff members to assist in implementation of the ASCVDREP. Frequent communication between the project manager and clinic staff was maintained throughout via phone calls, text messages, and frequent clinic visits. Clinicians' perceptions of the ASCVDREP were assessed via a post-implementation clinician survey. Findings/Results: Increasing the overall prevalence of global CVD risk screening was a primary outcome measure. Patient risk was stratified into low, borderline, intermediate, and high-risk categories; and medication intervention between risk groups was assessed and compared. Patients in the intermediate risk group were most likely to receive medication intervention. Screening identified patients with uncontrolled risk factors who could benefit from more aggressive risk reduction strategies, namely blood pressure-lowering, cholesterol-lowering, and daily asprin therapies. Conclusion/Recommendations: The literature supports global CVD risk assessment in the primary care setting. More aggressive risk-reduction therapies to manage CVD risk are needed. The ASCVDREP aided clinicians in the stratification of patient risk and may have increased the initiation and/or intensification of risk-reduction therapies. Clinicians agreed the ASCVDREP beneiftted patient education, risk perceptions, and possibly medication adherence.