Stfm Chicago Presentation

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Stfm Chicago Presentation

  1. 1. Cardiovascular Disease Prevention and Treatment in a Family Medicine Clerkship Bonnie T. Jortberg, MS, RD, CDE David Gaspar, MD Cynthia Villanueva, MS Department of Family Medicine University of Colorado at Denver and Health Sciences Center
  2. 2. Cardiovascular Disease Prevention: Why Teach this in Medical School? <ul><li>Approximately 120 million Americans have one or more chronic diseases </li></ul><ul><li>This accounts for 70-80%of health care costs </li></ul><ul><li>Epidemic of obesity and type 2 diabetes </li></ul><ul><li>2003 Association of American Medical Colleges survey of medical students reported only 46% believed that “appropriate time” had been devoted to nutrition instruction. </li></ul>
  3. 3. 1995 Obesity Trends* Among U.S. Adults BRFSS, 1990, 1995, 2005 (*BMI  30, or about 30 lbs overweight for 5’4” person) 2005 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  4. 4. CVD Curriculum <ul><ul><li>Colorado ranks 1 st for the lowest rate of CVD, but CVD still accounts for 32% of all deaths of Colorado residents </li></ul></ul><ul><ul><li>Colorado CVD rates higher in rural areas: our FM Clerkship is a rural rotation </li></ul></ul><ul><ul><li>Received grant funds for 3 years from the Colorado Department of Public Health and Environment to implement a CVD curriculum in our FM Clinical Training Block </li></ul></ul>
  5. 5. CVD Grant Objectives <ul><li>Objective #1: Provide education and outreach programs to rural Colorado physician-teachers (preceptors) on CVD evidence-based guidelines: </li></ul><ul><ul><li>Hold ½ day workshops in rural Colorado for our preceptors (interactive format, CME credit) </li></ul></ul><ul><ul><li>Content: </li></ul></ul><ul><ul><ul><li>CVD “Clinical Pearls” (medications, lifestyle modification, new research) </li></ul></ul></ul><ul><ul><ul><li>CVD/Obesity Guidelines </li></ul></ul></ul>
  6. 6. CVD Grant Objectives <ul><li>Objective #2: Implement a CVD prevention & early detection curriculum into the FM Clinical Training Block: </li></ul><ul><ul><li>CTB Orientation: </li></ul></ul><ul><ul><ul><li>Small group discussion of CVD case study </li></ul></ul></ul><ul><ul><ul><li>Students need to complete the CHD Risk Score card and develop tx plan for case study patient </li></ul></ul></ul><ul><ul><ul><li>Step counters </li></ul></ul></ul><ul><ul><ul><li>Patient Follow-up postcards </li></ul></ul></ul>
  7. 7. CVD Grant Objectives <ul><li>Objective #3: Translate CVD curriculum materials into Spanish and implement in CTB </li></ul><ul><ul><li>Materials translated </li></ul></ul><ul><ul><li>Will be implementing and evaluating materials this year </li></ul></ul>
  8. 8. Evaluation <ul><li>Objective #1: </li></ul><ul><ul><li>Pre/post workshop questionnaire </li></ul></ul><ul><ul><li>Results from 2 workshops: </li></ul></ul><ul><ul><ul><li>Overall evaluation of workshops = 4.6 (5.0 likert scale) </li></ul></ul></ul><ul><ul><ul><li>75% of participants state that they intend to change their practice habits as a result of attending the workshop </li></ul></ul></ul>
  9. 9. Evaluation <ul><li>Objective #2: </li></ul><ul><li>Pre/post CTB online questionnaire </li></ul><ul><li>Completion of 5 CHD Risk Score Cards </li></ul><ul><li>Patient Follow-up Postcards </li></ul><ul><li>Standardized Patient Testing </li></ul>
  10. 10. Evaluation (Pre/Post Questionnaire) True = 74% False = 26% True = 52% False = 48% Lowering LDL Cholesterol should be the primary target of CVD therapy? Yes = 93% No = 6% Yes = 50% No = 50% Have you ever assessed CVD risk in a patient? Post-CTB (N=109) Pre-CTB (N=122) Question
  11. 11. Evaluation (Pre/Post Questionnaire) Yes = 68% Sometimes = 32% No = 0% Yes = 43% Sometimes = 54% No = 3% Advise pt to quit smoking Yes = 40% Sometimes = 49% No = 11% Yes = 50% No = 50% Do you believe that you can influence patients to stop smoking? Post-CTB (N = 109) Pre-CTB (N = 122)
  12. 12. Evaluation (Pre/Post Questionnaire) Excellent = 23% Good = 43% Fair = 24% Poor = 8% N/A Rating of use of CHD Score Card with Pt Yes = 40% Sometimes = 48% No = 12% Yes = 11% Sometimes = 32% No = 57% Have you referred pts to Quitline/Quitnet Post-CTB (N = 109) Pre-CTB (N = 122)
  13. 13. Contact Information <ul><li>Bonnie Jortberg </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><ul><li>303.315.8078 </li></ul></ul><ul><ul><li>Thank you! </li></ul></ul>

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