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Canadian Journal of Public Health

, Volume 96, Issue 4, pp 294–298 | Cite as

A Community-based Program for Cardiovascular Health Awareness

  • Larry W. Chambers
  • Janusz Kaczorowski
  • Lisa Dolovich
  • Tina Karwalajtys
  • Heather L. Hall
  • Beatrice McDonough
  • William Hogg
  • Barbara Farrell
  • Alexandra Hendriks
  • Cheryl Levitt
Public Health in Action
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Abstract

Objective

The objective of the Cardiovascular Health Awareness Program (CHAP) is to improve the processes of care related to the cardiovascular health of older adults.

Participants

Two Ontario communities including family physicians (FP), pharmacists, public health units and nurses, volunteer peer health educators, older adult patients and community organizations.

Setting

Community pharmacies and family physician offices.

Intervention

CHAP is designed to close a process of care loop around cardiovascular health awareness that originates from, and returns to, the FP. Older patients are invited by their FP to attend pharmacy CHAP sessions. At these sessions, trained volunteer peer health educators (PHEs) assist patients both in recording their blood pressure using a calibrated automated device and in completing a cardiovascular risk profile. This information is relayed to their respective FP via an automated computerized database. Pharmacists and patients receive copies of the results. Based on these cumulative risk profiles, patients are advised to follow-up with their FP.

Outcomes

Of the FPs and pharmacists asked, 47% and 79%, respectively, agreed to participate in the project. 39% of older adult patients invited by their FPs attended the CHAP community pharmacy sessions. Of these, 100% agreed to having their risk profile, including their blood pressure readings, forwarded to their FP. Positive feedback about CHAP was expressed by the volunteer PHEs, the FPs and the pharmacists.

Conclusion

The community-based pharmacy CHAP sessions are a feasible way of improving patient, physician, and pharmacist access to reliable blood pressure measurements and to cardiovascular health information. A randomized trial is in progress that will assess the impact of CHAP on monitoring of blood pressure.

MeSH terms

Cardiovascular disease health promotion volunteer workers family practice community pharmacies 

Résumé

Objectif

L’objectif du programme communautaire de sensibilisation à l’hypertension CHAP (Cardiovascular Health Awareness Program) est d’améliorer les soins apportés aux personnes âgées en matière de santé cardiovasculaire.

Participants

Deux localités de l’Ontario, des médecins de famille, des pharmaciens, des infirmières de santé publique, des bénévoles-éducateurs en santé des pairs, des personnes âgées, des bureaux de santé publique et des organismes communautaires.

Milieu

Pharmacies communautaires et cabinets de médecins de famille.

Intervention

CHAP est un programme conçu pour boucler la boucle des soins en matière de sensibilisation à la santé cardiovasculaire qui débute et se termine avec le médecin de famille. Des personnes âgées reçoivent une invitation de leur médecin de famille de participer au programme CHAP. Au cours de ces séances, des éducateurs-bénévoles en santé des pairs ayant reçu une formation aident les patients à mesurer leur tension artérielle à l’aide d’un appareil calibré et automatisé, ainsi qu’à remplir un profil de risques cardiovasculaires. Ces renseignements sont ensuite transmis à leurs médecins de famille à l’aide d’une banque de données informatisée; les pharmaciens et patients reçoivent aussi des copies des résultats. Selon leur profil cumulé de risques, on conseille aux patients de consulter leur médecin.

Résultats

Parmi les médecins et pharmaciens approchés, 47% et 79% respectivement ont accepté de participer au projet. Chez les aînés, 39% des personnes ayant reçu une invitation de leur médecin de famille ont participé aux séances d’évaluation de la tension artérielle. De ce groupe, 100% ont consenti à ce que leur profil de risques et leurs chiffres tensionnels soient transmis au médecin de famille. Les bénévoles-éducateurs, médecins de famille et pharmaciens ont exprimé des commentaires positifs au sujet du CHAP.

Conclusion

Ces séances en pharmacies communautaires sont une façon viable d’améliorer l’accès des patients, des médecins et des pharmaciens à des mesures précises de la tension artérielle et à des renseignements sur la santé cardiovasculaire.

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References

  1. 1.
    Oxman AD, Thomson MA, Davis DA, Haynes B. No magic bullets: A systematic review of 102 trials of interventions to improve professional practice. CMAJ 1995;153(10):1423–52.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: A literature review. Int J Qual Health Care 1994;6(2):115–32.PubMedCrossRefGoogle Scholar
  3. 3.
    Wensing M, van der Weijden T, Grol R. Implementing guidelines and innovations in general practice: Which interventions are effective? Br J Gen Pract 1998;48:991–97.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Hulscher ME, Wensing M, Grol R, Weijden T, van Weel C. Interventions to improve the delivery of preventive services in primary care. Am J Public Health 1999;89(5):737–46.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: A systematic review of the effects of continuing medical education strategies. JAMA 1995;274(9):700–5.PubMedCrossRefGoogle Scholar
  6. 6.
    McClaran J, Kaufman D, Toombs M, Beardall S, Levy I, Chockalingam A. From death and disability to patient empowerment: An interprofessional partnership to achieve cardiovascular health in Canada. Can J Public Health 2001;92(4):I1–I9.Google Scholar
  7. 7.
    Kaufman D, McClaran J, Toombs M, Beardall S, Levy I, Chockalingam A. Achieving cardiovascular health through continuing interprofessional development. Can J Public Health 2001;92(4):I10–I16.PubMedGoogle Scholar
  8. 8.
    Law M, Wald N, Morris J. Lowering blood pressure to prevent myocardial infarction and stroke: A new preventive strategy (Executive Summary). Health Technol Assess 2003;7:31:(Executive summary).CrossRefGoogle Scholar
  9. 9.
    Lomas J, Haynes RB. A taxonomy and critical review of tested strategies for the application of clinical practice recommendations: From official to individual clinical policy. Am J Prev Med 1988;4(Suppl.):77–94.PubMedGoogle Scholar
  10. 10.
    Tu K, Davis D. Can we alter physician behavior by educational methods? Lessons learned from studies of the management and follow-up of hypertension. J Contin Educ Health Prof 2002;22:11–22.PubMedCrossRefGoogle Scholar
  11. 11.
    Campbell NR, Jeffrey P, Kiss K, Jones C, Anton AR. Building capacity for awareness and risk factor identification in the community: The blood pressure assessment program of the Calgary Fire Department. Can J Cardiol 2001;17(12):1275–79.PubMedGoogle Scholar
  12. 12.
    Feldman RD, Campbell N, Larochelle P, Bolli P, Burgess ED, Carruthers SG, et al. Canadian rec-ommendations for the management of hyperten-sion. CMAJ 1999;161(12):S1–S22.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Touyz RM, Campbell N, Logan A, Gledhill N, Petrella R, Padwal R. The 2004 Canadian recom-mendations for the management of hypertension: Part III — Lifestyle modifications to prevent and control hypertension. Can J Cardiol 2004;20(1):55–59.PubMedGoogle Scholar
  14. 14.
    Khan NA, McAlister FA, Campbell NR, Feldman RD, Rabkin S, Mahon J, et al. The 2004 Canadian recommendations for the management of hypertension: Part II — Therapy. Can J Cardiol 2004;20(1):41–54.PubMedGoogle Scholar
  15. 15.
    Joffres MR, Hamet P, MacLean DR, L’italien GJ, Fodor G. Distribution of blood pressure and hypertension in Canada and the United States. Am J Hypertens 2001;14:1099–105.PubMedCrossRefGoogle Scholar
  16. 16.
    National High Blood Pressure Prevention and Control Strategy. Summary Report of the Expert Working Group. Health Canada and the Canadian Coalition for High Blood Pressure Prevention and Control, 2000:6.Google Scholar
  17. 17.
    Joffres MR, Ghadirian P, Fodor JG, Petrasovits A, Chockalingam A, Hamet P. Awareness, treatment, and control of hypertension in Canada. Am J Hypertens 1997;10:1097–102.CrossRefGoogle Scholar
  18. 18.
    Naylor CD, Slaughter PM (Eds.). Cardiovascular Health Services in Ontario: An ICES Atlas. 1–11. Toronto, ON: Institute for Clinical Evaluative Sciences, 1999.Google Scholar
  19. 19.
    Kalwansky S. Treatment of Hypertension. Medicine Worth Paying For: Assessing Medical Innovations. Cambridge, England: Harvard University Press, 1995.Google Scholar
  20. 20.
    Hertert S, Bailey G, Cottinghan V, Carmody S, Egan D, Johnson P, Probstfield J. Community volunteers as recruitment staff in a clinical trial: The Systolic Hypertension in the Elderly Program (SHEP) experience. Control Clin Trials 1996;17:23–32.PubMedCrossRefGoogle Scholar
  21. 21.
    Mattu GS, Perry TL Jr, Wright JM. Comparison of the oscillometric blood pressure monitor (BPM-100Bcta) with the auscultatory mercury sphygmomanometer. Blood Press Monit 2001;6:153–59.PubMedCrossRefGoogle Scholar
  22. 22.
    Wright JM, Mattu GS, Perry Jr TL, Gelferc ME, Strange KD, Zorn A, Chen Y. Validation of a new algorithm for the BPM-100 electronic oscil- lometric office blood pressure monitor. Blood Press Monit 2001;6(3):161–65.PubMedCrossRefGoogle Scholar
  23. 23.
    Myers MG, Haynes RB, Rabkin SW. Canadian hypertension society guidelines for ambulatory blood pressure monitoring. Am J Hypertens 1999;12:1149–57.PubMedCrossRefGoogle Scholar
  24. 24.
    Hemmelgran BR, Zarnke KB, Campbell NR, Feldman RD, McKay DW, McAlister FA, et al. The 2004 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I—Blood pressure measurement, diagnosis and assessment of risk. Can J Cardiol 2004;20(1):31–40.Google Scholar
  25. 25.
    Davis DA, Thomson MA, Oxman AD, Haynes RD. Changing physician performance: A systematic review of the effects of continuing medical education strategies. JAMA 1995;274(9):700–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Thomson O’Brien MA, Oxman AD, Haynes RB, Davis DA, Freemantle N, Harvey EL. Local opinion leaders: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2000;2:CD.Google Scholar
  27. 27.
    Hutchinson B, Woodward CA, Norman GR, Abelson J, Brown JA. Provision of preventive care to unannounced standardized patients. CMAJ 1998;158(2):185–93.Google Scholar

Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Larry W. Chambers
    • 1
    • 2
    • 3
    • 4
    • 5
  • Janusz Kaczorowski
    • 5
    • 6
    • 7
  • Lisa Dolovich
    • 5
    • 7
  • Tina Karwalajtys
    • 5
  • Heather L. Hall
    • 1
  • Beatrice McDonough
    • 8
  • William Hogg
    • 1
    • 3
    • 9
    • 10
  • Barbara Farrell
    • 1
    • 11
  • Alexandra Hendriks
    • 1
  • Cheryl Levitt
    • 5
  1. 1.Elisabeth Bruyère Research InstituteOttawaCanada
  2. 2.Department of Epidemiology and Community MedicineUniversity of OttawaCanada
  3. 3.Department of Family MedicineUniversity of OttawaCanada
  4. 4.School of NursingUniversity of OttawaCanada
  5. 5.Department of Family MedicineMcMaster UniversityHamiltonCanada
  6. 6.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityCanada
  7. 7.Centre for Evaluation of MedicinesSt. Joseph’s HealthcareHamiltonCanada
  8. 8.City of Hamilton Public Health and Community Services DepartmentCanada
  9. 9.The Institute of Population HealthUniversity of OttawaCanada
  10. 10.CT Lamont CentreElisabeth Bruyère Research InstituteCanada
  11. 11.SCO Health ServiceOttawaCanada

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