Evaluation of “Deadly Trio” Chronic Disease Management and by sdfwerte

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									 Evaluation of “Deadly Trio”
Chronic Disease Management
and Cardiovascular Screening
   Report to PEC Board – 19th November
                  2009

   Amanda Lambert, Public Health Analyst
CHD prevalence vs QOF prevalence
            2005/06
     Chronic disease management
   Red reports issued to 5,410 (53%) of those on Deadly
    Trio registers
   Number not adequately treated reduced by 2,500
   Variation in statin prescribing due to: GP, concomitant
    aspirin, smoking, BP, cholesterol level
   Variation in aspirin prescribing due to: GP,
    concomitant statin, ethnicity, age
   No change in lifestyle factors ie weight and smoking
    Numbers with multiple risk factors
   6,600 with known CHD
       950 of these were smokers
          70 of these had BMI > 35
          430 had BP > 130
          450 had cholesterol > 4

   15,000 with known diabetes
       1,800 smokers
          200 BMI > 35
          880 BP > 130
          890 cholesterol > 4
                   Screening
   6,300 screened, response rate 24%
   3,500 screened by GP
   Uptake varied by practice
   Uptake higher where:
     GP had LES
     Phone numbers recorded
     Ethnicity recorded
     Black/Asian
     Non-smoker
             Outcomes of Screening
   Screened men at risk
       more likely to be placed on disease register (13% vs
        6%)
            Reducing the number with undiagnosed long term
             conditions
       29% eligible for statins, 26% eligible for aspirin
                 So far 38% of those eligible for statin (25% for aspirin) have
                  been prescribed them

   GP screening improves prescribing rates
                   Lack of HDL
   GPs send blood to several labs
   The following illustrates variation due to lab
    non-compliance
       HDL missing
          61% from UHB
          15% from City
    Translating evaluation into practice
   LES encourages GP screening
   Frequent red reports can cover more treatment areas
        Automated reporting
   Electronic feedback from alternative provider to GP
   GP and practice training
   Lab performance
   Improved lifestyle management
        My Action programme

								
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