Identification and assessment of risk

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Identification and assessment of risk

• Thanks to Dr Tom Marshall, University of
  Birmingham, for use of his slides in this
  presentation.

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Strategy for identification

• Targeted and systematic approach to
  identification of patients for primary prevention
• Use information already on primary care computer
  systems for patients gt 40 years estimate of
  risk and invite for full assessment prioritising
  those at highest risk
• Exclude patients with pre- existing CHD or
  angina, stroke or transient ischaemic attack
• or peripheral vascular disease.
• Exclude people who are already considered at high
  risk of CVD because of
• familial hypercholesterolaemia or
• other monogenic disorders of lipid
  metabolism or
• diabetes
• Discussion with patient and assessment
• Use Framingham equation for CHD for both estimate
  and full assessment
• 10 year Stroke/TIA 10
  year CHD

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Steps in Primary Prevention
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Red 10-year CVD risk gt20
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Results From 6 Inner-city Practices

• Data collected June 2005 and Feb 2006
• Number of patients aged 35-74 with the following
  risk factors recorded
• Smoking status
• Blood pressure within the past 3 years
• Cholesterol levels within the past 3 years

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Implementing systematic strategy

• Computer packages are available to do this
• Not include hard to reach groups
• Requires PCT involvement software support
• NHS vascular screening policy