Community Pharmacy Cardiovascular Disease Risk Assessment Service

Transcription

1 Appendix 8 Primary Care Trust Christchurch House Greyfriars Lane CV1 2GQ Telephone: Facsimile: Community Pharmacy Cardiovascular Disease Risk Assessment Service SUMMARY OF PREVALENCE OF CARDIOVASCULAR DISEASE IN COVENTRY Table 1 shows prevalence of CHD for based on QOF data 8, and the modelled prevalence (by APHO - Association of Public Health Observatories) and also the National QOF prevalence data for 6/7. prevalence of Heart Failure is also shown from QOF data and has been modelled by Doncaster Health (NB based on age and sex only). The national prevalence is also shown. The prevalence of Atrial Fibrilation for based on QOF data is also shown no modelled prevalence was available, but the national prevalence is also included. Table 1 PCT Population number QOF Prevalence % Modelled Prevalence % National QOF prevalence 6/7 Register Disease number CHD % 4% A 3.5% Heart failure % 1.34% D.8% Atrial fibrillation % - 1.3% Access to angioplasty and coronary artery bypass graft surgery (CABG) (from Atlas of variation) Figure 1 shows that access to angioplasty and CABG are highest in the most deprived quintile, however none of the quintiles have rates of access that are significantly different to the rate for all. Figure 2 shows the geodemographic category Disadvantaged Households has the highest rate of access, followed by the Multicultural Centres. Figure 3 shows the ethnic categories which had to be grouped to All White and Non-white as there were insufficient numbers to calculate DSRs for more specific groups. The Non-White group had the highest access rate. When the White population were analysed as White

2 British and White Irish, the Irish had a lower access rate compared to the White British. This may reflect differing rates of heart disease in the white and non white populations. Figure 1: Access to angioplasty and coronary artery bypass graft surgery By deprivation quintile directly standardised admission rate for angioplasty and CABG in all ages by IMD deprivation quintiles 4/5-7/8 rate per, least deprived next least deprived middle next most deprived most deprived DSR Figure 2: By geodemographic profile directly standardised admission rate for CABG and angioplasty in all ages by P2People categories 4/5-7/8 1 1 rate per, L. Disadvantaged Households I. Multicultural Centres C. Blossoming Families A. Mature Oaks G. Suburban Stability D. Rooted Households J. Urban Producers K. Weathered Communities H. New Starters DSR P 2 People and Places Beacon Dodsworth 4-7. Visit:

3 Figure 3: By Ethnicity directly standardised admission rate for CABG and angioplasty in all ages by ethnicity 4/5-7/ rate per, All White Non White White British White Irish Source: PCT Minimum Data Set DSR All Coded (white & non white) Mortality (this section taken from the Atlas of Variation) Figure 4 shows the directly standardised rate of mortality for all circulatory disease, and also of coronary heart disease which makes up a large proportion of the mortality. St Michaels and Foleshill have the highest rates of all circulatory disease while Woodlands and Wainbody have the lowest. For CHD the pattern is slightly different, St Michaels and Upper Stoke have the highest rates and Earlsdon and Bablake the lowest. The data is shown in table 2

4 Figure 4: Directly standardised rate of mortality from all circulatory disease and for Coronary Heart Disease by ward, 3-5 Directly standardised rates of mortality from all circulatory disease and for coronary heart disease rate per, StMichaels Foleshill Radford Upper Stoke Longford Binley & Willenhall Holbrook Sherbourne Henley Lower Stoke Westwood Wyken Cheylesmore Whoberley Earlsdon Bablake Wainbody Woodlands all circulatory Coronary heart disease circulatory CHD Source: PCT Minimum Data Set Table 2 All Circulatory Diseases < 75 Years All Coronary Heart Disease < 75 Years Ward DSR Ward DSR St Michaels St Michaels 15.3 Foleshill Upper Stoke 82.2 Radford Radford 77.6 Upper Stoke Longford 7.9 Longford Binley & Willenhall 7.2 Binley & Willenhall Foleshill 67.6 Holbrook Holbrook 64.6 Sherbourne 18.1 Sherbourne.6 Henley 12.2 Wyken 56.3 Lower Stoke 12. Lower Stoke 54.1 Westwood 12. Wainbody 52.9 Wyken 99.3 Henley 52.6 Cheylesmore 9. Whoberley 45.6 Whoberley 87.3 Cheylesmore 42.7 Earlsdon 77.8 Westwood 42.1 Bablake 7.8 Woodlands 39.7 Wainbody 68.4 Bablake 37. Woodlands 63.4 Earlsdon Figure 5 shows deaths by quintile of deprivation. Deaths are much more frequent in the least advantaged fifth of the population, but have been falling significantly over time in this group, hence narrowing inequalities.

5 Figure 5: Deaths from circulatory disease by quintile of deprivation (under 75) Directly standardised mortality rate from all circulatory disease by deprivation quintile (under 75) 25 rate per Source: ONS least deprived next least middle next most most deprived

6 Figure 6 looks at circulatory disease for all ages. The gap between the priority Neighbourhoods (PN) and the Rest of the City (RoC) is narrowing and inequalities may have been reduced to zero by around 11, assuming this is biologically possible. Figure 17 shows a similar pattern, but this time for the under 75s. Figure 6: Reducing inequalities circulatory disease (all ages) all circulatory disease - all ages - directly standardised mortality rates based on 3 year rolling averages 5 rate per, RoC PN Linear (PN) Linear (RoC) Figure 4: Reducing inequalities circulatory disease (under 75s) circulatory disease - under 75 - directly standardised mortality rates based on 3 year rolling averages 3 25 rate per, Source: ONS RoC PN Linear (PN) Linear (RoC)

7 Initially it is suggested that pharmacies are selected from those that have expressed an interest. This selection process should ensure that successful pharmacies meet the defined criteria for inclusion and allow a sufficient geographical spread but with a concentration in areas of greater need. The target date for implementation would be. 9. The proposed pilot would run initially for 12 months. A decision would be made prior to the end of this period whether to extend the programme for a further year. Experience from this programme could then be used to inform a decision about roll out the service within or outside the pharmacy sector.