Cardiovascular Disease Prevention: Evidence-Based Interventions for the Corryong community
CARDIOVASCULAR DISEASE DEFINED
Cardiovascular disease is a group of conditions affecting the blood vessels and the heart. Also known as heart and blood vessel disease, CVC relates to the atherosclerosis, associated with the development of the various diseases, including heart attack, stroke, arrhythmia, heart failure, and heart valve problems, among others. Development of the atherosclerosis, as the basis for most of the cardiovascular diseases, occurs when plaque upsurges within arteries’ walls. The expansion causes narrowing of the arteries and makes it difficult for the blood to flow adequately through them (Ngian et al., 2012). A resulting clot can lead to a complete stoppage of the flow, causing a heart attack or stroke.
EXTENT OF THE PROBLEM
- Including stroke and heart disease, cardiovascular diseases are the main causes of death in globally and in Australia, with 45,600 deaths being reported in 2011 (Heart Foundation, n.d.).
- Despite the fact that there has been an improvement, the disease continues to be a major burden for the economy of Victoria and the communities therein, including Corryong.
- The disease affects over 7 million people in the country, preventing 1.4 million from having a full life due to disability resulting from CVD (Heart Foundation, n.d.).
- The data is a reflection of the situation in all parts of the country, including Corryong in Australia.
- From a needs analysis, it becomes evident that there is a need to develop strategies to reduce the prevalence of the disease in the community (Guzys, 2013).
POTENTIAL FOR PREVENTION
Most of the risk factors for most cardiovascular diseases, including high levels of cholesterol, high blood pressure, excessive weight, poor dietary choices, diabetes, and smoking, are preventable. Evidence-based prevention through behavior change is a subject that has attracted a great deal of research (De Gruyter, Ford, & Stavreski, 2016).
The Risk Factors for Cardiovascular Disease
Effective prevention necessitates an understanding of the risk factors for cardiovascular disease. The challenging factors include genetic predisposition, advancing age, gender, and ethnicity. Risk factors can be modified, including behavioral factors like inadequate physical activity, tobacco smoking, poor diet, and excess consumption of alcohol. A major role is also played by biomedical factors, including high blood cholesterol, high blood pressure, and overweight and obesity (The Department of Health, n.d.).
Many of the risk factors for cardiovascular disease are common to other chronic conditions, including chronic kidney disease and diabetes. The interaction between the chronic diseases is complicated and not adequately comprehended. Nonetheless, it is commonly known that the risk of cardiovascular disease increases with diabetes (The Department of Health, n.d.). Compared to the general population, those with diabetes have two times the risk of developing cardiovascular disease. Diabetes can also increase the risk of stroke five times higher and the possibility of heart attack up to ten times.
The brochure is created with the aim of sending a message to the various stakeholders within the Corryong community, primarily founded on the role they have to play in preventing cardiovascular diseases in the community. The information is aimed at the community advocates, public health program planners, primary care providers, educators, and policymakers, who are the main opinion leaders in the community and can lead the change (The Department of Health, n.d.).
Programs, services, and policies could be implemented within the community to prevent and control cardiovascular diseases. Basically, prevention entails the means of controlling the risk factors for the diseases (Taylor et al., 2013). The idea is to provide a wide range of choices regarding interventions such that the policy makers have choices for those that are adequate depending on the factors unique to their communities.
Community Preventive Services
An important guide directing the use of community services in the prevention of cardiovascular diseases is an important resource for public health. Research indicates that effective use of community members is a major resource in achieving behavior change since the problem exists within the context of a community. Community health workers are among the important stakeholders in the process (Ettehad et al., 2016). The main goal is using evidence-based approaches and research findings on public health policies and interventions to improve health and promote safety.
A recommended approach is the development of a community preventive services task force involving diverse members of the Corryong community, including public health and prevention experts, who will spearhead the implementation of the recommended strategies to prevent cardiovascular diseases. The task force should use information from research based on the actual reality of Corryong community and what will work based on the findings. In addition, the oversight is expected to provide insight over the implementation of the created services, programs, and policies at the community level.
SUMMARY OF RECOMMEND PREVENTION STRATEGIES
Various evidence-based strategies should be implemented in the Corryong community to achieve success in preventing cardiovascular diseases in the community. Some of these strategies are discussed below:
Implementation of Clinical Decision-Support Systems at the Point-of-Care
The idea is for the health service providers in the community to support and implement services such as screening for cardiovascular disease risk factors. Prevention is always effective when the risk factors are identified and interventions implemented promptly. Preventive care services for cardiovascular disease, medical examinations, and treatment can be better where health care systems in the community implement clinical decision-support systems. The systems are computer-based information systems created to assist the providers of care by offering the information of the patients when they visit the health care facility. Health care service providers will be able to successfully screen the risk factors using the clinical decision-support systems (Nidorf et al., 2013). Besides, they will be able to assess the risk of the patient to develop the disease and pass the information to the patient where the elevated levels of risk are identified.
Reducing Out-of -Pocket Costs for Patients
Reduction of the out-of-pocket cost for medication taken to control cholesterol and blood pressure levels can be adopted as an intervention on its own or together with others, such as team-based care. Given that almost half of the residents have personal income <$400/week, high cost of care can be a barrier to dealing with the risk factors. Thus, the intervention has the potential for increased adherence to medication, consequently helping to augment the percentage of patients meeting the proposed blood pressure objective by an 18% median and 13% for those achieving the goal of reduced level of cholesterol (Cobiac et al., 2012). Such efforts will play an important role in reducing the prevalence of cardiovascular diseases.
Implementing Team-Based Care in Health Care Systems
Such groups are made up of health care teams working together to achieve the goal of improved care to the patients. The team, which is highly coordinated, is made up of the patient, the provider of primary care, and other professionals in health care such as nurses, dietitians, and pharmacists). Such interventions allow for effective communication between the members of the team, regular monitoring of the progress of the patient, utilization of clinical guidelines by the members of the team, and engaging the patient in self-care and management. The intervention can lower the risk of cardiovascular disease by enhancing control (Record et al., 2015). Research has revealed that health care systems that use team-based care increase the percentage of those with effectively managed blood pressure by a 12% median, compared to regular care.
USE OF INFORMATION
The policy makers in choosing the most appropriate intervention strategy in the community and the health care facilities can use the information in this fact sheet. It is useful in introducing medical decision-support systems to adopt guidelines for the health care systems at the point of care. The information is useful given that proper use will reduce the costs for treatment and management of high cholesterol and high blood pressure in patients. The information will allow integration of multidisciplinary team-based care in health care organizations, comprising of patients, the primary care providers, and other health care professionals like nurses, dietitians, pharmacists, social workers and health workers at the community level to enhance prevention of cardiovascular diseases.
PUTTING THE RECOMMENDATIONS TO WORK
The information is for the decision makers within the community’s healthcare system. Practitioners, community leaders, or whoever with an influence on the community’s health can use the recommendations to prevent the prevalence of cardiovascular disease by targeting the risk factors (Gómez-Pardo et al., 2016). The provided guidelines are a blueprint for success in preventing cardiovascular disease.
For More information
- The Heart Foundation website is a source of more information on cardiovascular in Australia.
- The National Stroke Foundation website is a source of more information on stroke in Australia.
- The Australian Institute of Health and Welfare website has information on vascular diseases’ monitoring and surveillance, such as publications on cardiovascular disease.
- Heart Problems and Cardiovascular Health information can be obtained from Healthdirect Australia.
- The NHMRC website has more information on research funding.
Cobiac, L. J., Magnus, A., Barendregt, J. J., Carter, R., & Vos, T. (2012). Improving the cost-effectiveness of cardiovascular disease prevention in Australia: a modelling study. BMC Public Health, 12(1), 398.
De Gruyter, E., Ford, G., & Stavreski, B. (2016). Economic and social impact of increasing uptake of cardiac rehabilitation services–a cost benefit analysis. Heart, Lung and Circulation, 25(2), 175-183.
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., … & Rahimi, K. (2016). Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. The Lancet, 387(10022), 957-967.
Gómez-Pardo, E., Fernández-Alvira, J. M., Vilanova, M., Haro, D., Martínez, R., Carvajal, I., … & Santos-Beneit, G. (2016). A comprehensive lifestyle peer group–based intervention on cardiovascular risk factors: the randomized controlled Fifty-Fifty Program. Journal of the American College of Cardiology, 67(5), 476-485.
Guzys, D. (2013). Community needs assessment. An Introduction to Community and Primary Health Care in Australia, 91.
Heart Foundation (n.d.). Prevalence of Cardiovascular Disease (CVD) in Australia, retrieved from https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia/prevalence-of-cardiovascular-disease-cvd-in-australia
Heart Foundation (n.d.). Victorian Heart Maps. Retrieved from https://www.heartfoundation.org.au/programs/victorian-heart-maps
Ngian, G. S., Sahhar, J., Proudman, S. M., Stevens, W., Wicks, I. P., & Van Doornum, S. (2012). Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis. Annals of the rheumatic diseases, 71(12), 1980-1983.
Nidorf, S. M., Eikelboom, J. W., Budgeon, C. A., & Thompson, P. L. (2013). Low-dose colchicine for secondary prevention of cardiovascular disease. Journal of the American College of Cardiology, 61(4), 404-410.
Record, N. B., Onion, D. K., Prior, R. E., Dixon, D. C., Record, S. S., Fowler, F. L., … & Pearson, T. A. (2015). Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010. Jama, 313(2), 147-155.
Taylor, F., Huffman, M. D., Macedo, A. F., Moore, T. H., Burke, M., Davey Smith, G., … & Ebrahim, S. (2013). Statins for the primary prevention of cardiovascular disease. The Cochrane Library.
The Department of Health (n.d.). Cardiovascular disease, retrieved from http://www.health.gov.au/internet/main/publishing.nsf/Content/chronic-cardio