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Stfm Chicago Presentation Stfm Chicago Presentation Presentation Transcript

  • 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
  • Cardiovascular Disease Prevention: Why Teach this in Medical School?
    • Approximately 120 million Americans have one or more chronic diseases
    • This accounts for 70-80%of health care costs
    • Epidemic of obesity and type 2 diabetes
    • 2003 Association of American Medical Colleges survey of medical students reported only 46% believed that “appropriate time” had been devoted to nutrition instruction.
  • 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%
  • CVD Curriculum
      • Colorado ranks 1 st for the lowest rate of CVD, but CVD still accounts for 32% of all deaths of Colorado residents
      • Colorado CVD rates higher in rural areas: our FM Clerkship is a rural rotation
      • 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
  • CVD Grant Objectives
    • Objective #1: Provide education and outreach programs to rural Colorado physician-teachers (preceptors) on CVD evidence-based guidelines:
      • Hold ½ day workshops in rural Colorado for our preceptors (interactive format, CME credit)
      • Content:
        • CVD “Clinical Pearls” (medications, lifestyle modification, new research)
        • CVD/Obesity Guidelines
  • CVD Grant Objectives
    • Objective #2: Implement a CVD prevention & early detection curriculum into the FM Clinical Training Block:
      • CTB Orientation:
        • Small group discussion of CVD case study
        • Students need to complete the CHD Risk Score card and develop tx plan for case study patient
        • Step counters
        • Patient Follow-up postcards
  • CVD Grant Objectives
    • Objective #3: Translate CVD curriculum materials into Spanish and implement in CTB
      • Materials translated
      • Will be implementing and evaluating materials this year
  • Evaluation
    • Objective #1:
      • Pre/post workshop questionnaire
      • Results from 2 workshops:
        • Overall evaluation of workshops = 4.6 (5.0 likert scale)
        • 75% of participants state that they intend to change their practice habits as a result of attending the workshop
  • Evaluation
    • Objective #2:
    • Pre/post CTB online questionnaire
    • Completion of 5 CHD Risk Score Cards
    • Patient Follow-up Postcards
    • Standardized Patient Testing
  • 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
  • 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)
  • 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)
  • Contact Information
    • Bonnie Jortberg
      • [email_address]
      • 303.315.8078
      • Thank you!