Promoting Excellence in Cardiovascular Disease Prevention and Rehabilitation Diabetes and Obesity Meeting the Challenges in Physical Activity and Exercise Jenni Jones BACPR President Friday 11 th May 2012, BACPR-EPG, Aston
The BACPR Members Education Membership services and communications Conference BACPR- EPG Executive Coordinating Group Council Ordinary officers, co-opted members and affiliate group representatives Employed staff
Age-adjusted Percentage of U.S. Adults with Obesity or Diagnosed Diabetes Obesity (BMI 30 kg/m 2 ) O BE 1994 2000 2009 S I T Y Diabetes D IA No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0% 1994 2000 2009 B ET E S No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics
The Diabetes Epidemic: Global Projections 2010 2030 IDF. Diabetes Atlas 5 th Ed. 2011
Prevalence of Diabetes (UK) As part of QOF general practices will register the number of people with diabetes = prevalence Country Prevalence Number of people England 5.5 % 2,455,937 Northern Ireland 3.8 % 72,693 Scotland 4.3 % 223,494 Wales 5.0 % 160,533 UK average = 4.45 %
Obesity Worldwide, at least 2.8 million people die each year as a result of being overweight or obese. 34% of adults over the age of 20 BMI > 25 kg/m2 9.8% of men and 13.8% of women > BMI 30 kg/m2) World map showing the prevalence of BMI > 25 in males (ages 20+, age standardized)
Hospital centres Primary Care centres Edinburgh Wansbeck Glasgow Darlington Belfast Sheffield Hull Northern Ireland Doncaster Burton-upon-Trent Derby Bangor Cardiff Salisbury Derby Leicester Norwich Cambridge London Camberwell Brighton West Midlands Shropshire Abergavenny Cheltenham Bourton-on-the- Water Lincoln Luton High Wycombe London Medway
Aspire-2-Prevent: Diabetes and Obesity Coronary Patients High risk individuals 100 90 80 70 60 50 40 30 20 10 0 34 76 18 Obesity** Central DM Self Fasting Raised obesity** glucose Obesity*** reported fasting 7 diabetes glucose 4 100 90 80 70 60 50 40 30 20 10 0 76 47 44 1.4 Obesity* Central DM DM Fasting Raised obesity** Obesity glucose fasting 7 glucose *Body mass index 30 kg/m² **Waist circumference 88 cm for women and 102 cm for men Self reported DM; in those without diabetes
Cardiac Rehabilitation Reduces: All cause mortality by 11-26% 1,2,3,4 Cardiac mortality by 26 36% 1,2,3,4 Morbidity 4,5 www.bacpr.com Unplanned admissions by 28-56% 6,7 Improves: Quality of life 8 Functional capacity 8 Supports: Early return to work 8 The development of self-management skills 8 The evidence for physical activity and exercise is compelling
BACPR Standards and Core Components (2012) Early assessment and goal setting Multidisciplinary biopsychosocial approach in order to best influence uptake, adherence and long-term healthier living. Measurable outcomes Appropriately resourced Cost effective Cost saving
Robust, Comprehensive and Universal Valid for primary prevention Valid for rehabilitation Valid for secondary prevention Valid for any service in cardiovascular health and well-being!
BACPR Next steps Performance Indicators Tool Implementation tool-kits Competences frameworks Research Education and training
BACPR Promoting Excellence in Cardiovascular Prevention and Rehabilitation BACPR Annual Conference in collaboration with CRIGS Thursday 4 & Friday 5 th October, 2012, Edinburgh University Pollock Halls Campus Setting the Standards Challenges and Achievements SLIDES FROM TODAY...
The BACPR Standards and Core Components Continue to strive for our ultimate goal, namely to ensure that all eligible patients receive high quality care in cardiovascular disease prevention and rehabilitation Consolidating, Collaborating & Championing for High Quality Care THANKYOU and ENJOY YOUR BACPR-EPG STUDY DAY Promoting Excellence in Cardiovascular Disease Prevention and Rehabilitation
References 1. Heran et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No: CD001800. DOI: 10.1002/14651858.CD001800.pub2. 2. Taylor on behalf of the 2011 Cochrane Review Authors. The RAMIT trial: its results in the context of 2012 Cochrane review. Heart 2012; 98: 672-3 3. Taylor et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116(10):682-697. 4. Lawler et al. Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: A systematic review and meta-analysis of randomized controlled trials. Am Heart J Oct 2011; 162: 571-584. 5. Clark et al. Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease. Ann Intern Med 2005; 143(9): 659-672. 6. Lam et al. The effect of a comprehensive cardiac rehabilitation program on 60-day hospital readmissions after an acute myocardial infarction. J Am Coll Cardiol 2011; 57:597, doi:10.1016/s0735-1097(11)60597-4. 7. Davies et al. Exercise training for systolic heart failure: Cochrane systematic review and metaanalysis. Eur J Heart Fail 2010; 12(7): 706-715. 8. Yohannes et al. The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life. Journal of Clinical Nursing 2010; 19(19-20):2806-2813.