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Integration of absolute cardiovascular disease risk assessment into routine blood cholesterol testing at pathology
Niamh Chapman1, Ricardo Fonseca1, Leigh Murfett2
1Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Insights
Integrating cardiovascular disease (CVD) risk assessment into pathology services is feasible and preferred by patients. This approach can improve guideline-directed care for primary prevention in general practice.
Area of Science:
- Cardiovascular Disease Prevention
- Health Service Delivery
- Preventive Cardiology
Background:
- Absolute cardiovascular disease (CVD) risk assessment is crucial for primary prevention but faces limited uptake in general practice.
- Pathology services offer a potential avenue to enhance CVD risk assessment by integrating it with routine cholesterol testing.
Purpose of the Study:
- To evaluate the feasibility of incorporating absolute CVD risk assessment into pathology services.
- To gauge patient acceptance and preference for this integrated service model.
Main Methods:
- 299 patients (45-74 years) undergoing cholesterol tests had CVD risk factors (blood pressure, age, sex, smoking, diabetes) assessed via a computer application.
- Absolute CVD risk scores were reported to referring practitioners.
- Patient satisfaction and preferences were assessed via questionnaires and follow-up interviews.
Main Results:
- 90% of patients received absolute CVD risk reports.
- 95% found the assessment time acceptable, and 91% found the application easy to use.
- 78% preferred pathology services for risk assessment, with 75% of follow-up patients consulting a doctor about CVD risk factors.
Conclusions:
- Assessing absolute CVD risk within pathology services is feasible and highly acceptable to patients.
- This integrated model shows promise for increasing the uptake of guideline-directed care for CVD prevention in primary care settings.
Background:
Absolute cardiovascular disease (CVD) risk assessment is recommended for primary prevention of CVD, yet uptake in general practice is limited. Cholesterol requests at pathology services provide an opportunity to improve uptake by integrating absolute CVD risk assessment with this service.
Objective:
This study aimed to assess the feasibility of such an additional service.
Methods:
Two-hundred and ninety-nine patients (45-74 years) referred to pathology services for blood cholesterol had measurement of all variables required to determine absolute CVD risk according to Framingham calculator (blood pressure, age, sex, smoking and diabetes status via self-report). Data were recorded via computer-based application. The absolute risk score was communicated via the report sent to the referring medical practitioner as per usual practice. Evaluation questionnaires were completed immediately post visit and at 1-, 3- and 6-month follow-up via telephone (n = 262).
Results:
Absolute CVD risk reports were issued for 90% of patients. Most patients (95%) reported that the length of time for the pathology service assessment was acceptable, and 91% that the self-directed computer-based application was easy to use. Seventy-eight per cent reported a preference for pathology services to conduct absolute CVD risk assessment. Only 2% preferred a medical practitioner. Of follow-up patients, 202 (75%) had a consultation with a medical practitioner, during which, aspects of CVD risk prevention were discussed (cholesterol and blood pressure 74% and 69% of the time, respectively).
Conclusions:
Measurement of absolute CVD risk in pathology services is feasible, highly acceptable among middle-to-older adults and may increase uptake of guideline-directed care in general practice.
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