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A heart health assessment programme in general practice in County Kilkenny, Ireland
Insights
The Health Assessment Programme (HAP) successfully standardized coronary heart disease (CHD) risk factor assessment in general practice. This initiative proved feasible and acceptable to patients, highlighting its preventive potential.
Area of Science:
- Public Health
- Preventive Medicine
- General Practice
Background:
- Coronary heart disease (CHD) risk factors require standardized assessment in primary care.
- General practice settings offer opportunities for early detection and intervention.
- The Irish College of General Practitioners established a program to address these needs.
Purpose of the Study:
- To standardize the examination and recording of CHD risk factors within general practice.
- To evaluate the feasibility and patient acceptability of a Health Assessment Programme (HAP).
- To assess CHD risk factor prevalence in a target population aged 40-49 years.
Main Methods:
- Established criteria for classifying demographic data, medical history, and risk behaviors.
- Measured height, weight, and blood pressure; collected blood for total cholesterol.
- Provided post-assessment counseling for identified risk factors.
Main Results:
- 2102 assessments completed by 41 general practitioners in 16 months (29% target group uptake).
- HAP participants showed no significant differences in smoking or BMI compared to baseline, but had lower median cholesterol (5% reduction).
- 16% of HAP clients had elevated diastolic blood pressure (≥90 mm Hg).
Conclusions:
- The Health Assessment Programme (HAP) is feasible for measuring CHD risk factors in diverse general practice settings.
- The HAP format supports a preventive approach and is well-accepted by patients.
- Standardized assessment facilitates early identification and management of cardiovascular risk.
Abstract:
The Kilkenny Faculty of the Irish College of General Practitioners and the Kilkenny Health Project have established a Health Assessment Programme (HAP) to standardise the examination and recording of coronary heart disease (CHD) risk factors in general practice. Criteria were agreed for classification and coding of demographic data, relevant medical history and risk behaviours. Height, weight and blood pressure are measured and venous blood sample is taken for total cholesterol estimation. The assessment is followed by appropriate counselling. The HAP was first targetted at men and women aged 40 to 49 years. During the first 16 months of the programme, 2102 assessments were carried out by 41 general practitioners, which represents 29% of the target group. Those taking part had a lower social class distribution when compared with participants in the KHP baseline survey in 1985. There were no significant differences between the two groups in smoking prevalence or in the distribution of body mass index. Median cholesterol was 5% lower in the HAP group than at the baseline survey. 16% of the HAP clients had diastolic blood pressures of 90 mm Hg or more. The HAP has demonstrated that it is feasible to measure CHD risk factors in a variety of general practice settings. The format facilitates a preventive orientation and has proved acceptable to patients.