To fully participate in this session: Please obtain a Framingham Risk Calculator google: My Health Alberta Risk Calculator click: Heart Disease Risk

Transcription

1 To fully participate in this session: Please obtain a Framingham Risk Calculator google: My Health Alberta Risk Calculator click: Heart Disease Risk Calculator

2 Worksite Screening and the Unknown Burden of Risk The Cardiovascular Health and Stroke Strategic Clinical Network TM

3 Faculty/Presenter Disclosure Faculty: Agnes Lehman Mohammad Rashead Anthony Train Carolyn Walker Relationships that may introduce potential bias and/or conflict of interest: No relationships to declare.

4 What to Expect.. Agenda: Background Vascular Risk Worksite Screening Information Getting Down and Dirty POC Screening, Tools, Resources, and Opportunities Let s Talk Facilitated Discussion So What?

5 What to take away Understand our worksite screening model How to complete a quick-and- dirty cardiovascular (CV) risk assessment Recognize key strategies to reduce vascular risk Identify opportunities to embed worksite screening strategies into your existing programs Identify the tools / resources

6 Prevalence Over 90% have at least 1 vascular risk factor Vascular Disease is the major cause of death and disability in Alberta and in Canada

7 Vascular Risk Reduction (VRR) Interventions in CvHS Strategic Clinical Network Primary Care: Systematic screening of vascular risk in PCNs (TOP). o Alberta Screening and Prevention (ASaP) Project Integrated Approach: risk management clinics (e.g. diabetes, Stroke, HT, cardiac rehab) Community Pharmacy based screening and risk management o RxEACH Project Enhanced Lipid Reporting: Laboratory-based cardiovascular risk assessment Worksite-based screening and risk management Knowledge Translation (KT) program involving 8 key Alberta Healthcare Organizations (consistent evidence based messages) o Prescriptions for Healthy Living, video on statins for patients and for HCP, network of champions, many more resources.

8 5 Priorities of the VRR Knowledge Translation Program Cardiovascular risk assessment Enhanced lipid management Tobacco reduction Healthy eating Physical activity

9 Top causes of death in Canada 2011 Primary Vascular Risk Outcome Secondary Vascular Risk Outcome Deaths Source Stats Can

10 Health risks and death in Canada >64000 deaths Top priority for VRR Secondary priority for VRR

11 6.5 million adults are intermediate-high risk serious events (heart attack/stroke) could be prevented NNT = 17 We need to do better!

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15 Statin Myths

16 Jealousy of a hypertension expert Dr. Norm Campbell There is no antihypertensive drug that is nearly as safe and effective as a statin. Where indicated in moderate and high vascular risk, there is likely no other drug class as under utilized as statins. Statins have a very substantive reduction in death for people with known vascular disease but are hugely underutilized

17 Let s get thinking What is currently being done to identify risk? What is currently being done to manage risk? What could be done differently to identify risk? What could be done differently to manage risk?

18 Timer 2 minutes START

19 Move Timer 2 minutes START

20 The Pilot

21 The Pilot

22 The Pilot

23 The Pilot

24 The Pilot Outcomes: 41% of the workers screened were at moderate or high risk. 17% Moderate Risk High Risk 59% 24% Low Risk

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26 The Pilot This is a huge step in a culture shift towards a healthy work environment. We would do this project again in a heartbeat, healthier workers It s a no brainer! ~ANC Leadership

27 Case Study

28 Case 36 yo male, smoker, seen for removal of sutures post hernia repair Hx: Father had MI and CABG at age 38. Initial exam: BP 145/98 Total Chol 7.14 HDL 0.94 LDL 5.26

29 Any RED FLAGS?

30 Case What is this patient s cardiovascular risk?

31 Case

32 Case What actions would you take? Support Resources Website living.ca Alberta Quits:

33 Case F/U 2.5 months later: Suffered an MI Motivated to quit smoking, make lifestyle changes BP 120/80 Total Chol 4.29 HDL 1.07 LDL 2.77

34 From elements we ve described in this worksite model which apply to vulnerable populations : 1. What key elements would be important to include in your community? 2. What tools and resources could be helpful?

35 If you could do anything How could you embed any of these worksite strategies into your existing programs? 1. What big idea would you recommend? 2. What first step would you take to get started?

36 2016 It has been a pleasure to work alongside the AHS staff at Chinook Regional Hospital and the clinic that was put on for us is an extension of that great working relationship. Stephanie Laing, Project Co-ordinator

37 Corinna Hartley, RN, Stroke Coordinator, Chinook Regional Hospital Kimberley Nelson, RN, BN, Stroke, Vascular Risk and Weight Management Educator Primary Goals: To increase the knowledge of personal vascular risk factors To provide education to enable participants to make long-term lifestyle changes to improve their vascular health. To encourage regular follow up with health care providers to improve risk factor management To develop preventive educational strategies to address health concerns identified within the workplace

38 Stuart Olsen Project Design Stage One: Past medical history BP Height and Weight Waist circumference Point of care testing o HgA1C o Lipid Levels Vascular Risk Assessment

39 Stuart Olsen Project Design Stage One: A Vascular Risk Scorecard was provided in an educational tool kit Timely education on how to decrease their vascular risk Referral were made to community programs for follow up Referral letters were sent to Physician's for all patients identified At risk Personal Vascular Risk Counseling

40 Stuart Olsen Project Results 61.1% regularly use tobacco 75.9% use alcohol above the daily recommended consumption 70.4% were encouraged to make an appointment with their doctor 16.7% had high Blood Pressure 2 people had elevated A1C 81.5% had high cholesterol levels 18.5% were counselled for Weight Management Education is Key

41 Impact of the Project The Boys in the Lunch Room

42 Support Resources Available for clinicians and support of patient s healthy living efforts. Prescriptions For Healthy Living: Vascular Risk Reduction Resources: Includes prescriptions, user guide, patient handouts, posters, toolkits (healthy eating, physical activity, tobacco cessation), pocket cards, statin support resources, slide sets, videos, etc.

43 Key Messages: Find those at risk! Healthy Living: All those with vascular risk should be encouraged to implement Healthy Living behaviours such as: o Healthy Eating o Being Active o Becoming Tobacco Free Statins: All those at High Risk or Known Vascular Disease should be treated with a statin.