Pilot programme: A programme designed to reduce cardiovascular disease and connect hospitals to general practitioners (GPs) via a database of shared patient information could significantly diminish strokes and heart attacks in high-risk patients, a new report shows. Brandon Glenn reports.
Results from the pilot programme, Reduction of Heart Attack Through Prevention (RHASP), indicate a reduction in patients' blood pressure and cholesterol levels, according to the report.
This was achieved through enhanced collaboration between GPs and hospitals, which led to a sharp increase in the amount of patients being prescribed the proper drugs, and improved means of monitoring patients' progress.
Per annum, deaths in the Republic from cardiovascular disease are at 176 per 100,000 residents, compared with a European Union (EU) average of 108. The number of premature deaths - individuals under 65 - from cardiovascular disease is nearly twice as high in the Republic as it is in the rest of the EU, at 46 deaths per 100,000 residents in the Republic compared with 25 in the EU. Forty-one per cent of all deaths in the Republic are a result of cardiovascular disease, compared with 26 per cent caused by cancer.
Moreover, the Republic's "ageing population profile is likely to result in a large increase in the number of people with cardiovascular disease in the years to come", the report said.
The pilot programme has been in place for 12 months at six GP surgeries in northern Dublin. The system connects GPs to a database of about 25,000 patient records maintained at Beaumont Hospital.
The shared data make it easier for hospitals and GPs to provide the proper level of treatment for patients, with high-risk patients better served by hospitals and low-risk patients better served by GPs.
All of the GPs in the pilot had nurses, who represent an essential element of RHASP. Nurses' duties include performing initial assessments and inputting data into the system. With only about half of the Republic's GPs employing nurses, questions emerge about how widely RHASP can be implemented, given the current situation.
The total cost of the pilot was €390,000. The per-practice cost was about €16,000, which covered database licensing fees, training and computer hardware upgrades.
However, the report estimates that the programme could be rolled out to an additional 50 practices over three years at the cost of about €7,500 per practice. Implicit in the cost estimate is that the GPs would need very little hardware investment, according to Bill Rickard, managing director of dabl, the company that provided RHASP's software.
An application to extend RHASP to 50 more GPs throughout the Republic is currently under review by the Department of Health, with a decision due "very shortly", according to the department's Peter Lennon. Extending the programme to include 20,000 high-risk patients in the Eastern Regional Health Authority over 10 years could result in the prevention of more than 1,000 heart attacks and 500 strokes, according to Prof Eoin O'Brien, who helped co-ordinate the project at Beaumont Hospital.