Medicine/ Public health

Arutiounov Yuri Artemovich

Clinical-diagnostic Center of the First Moscow Medical University

Cardiovascular diseases risk management: outpatient setting algorithm

 

Cardiovascular diseases (CVD) is a large group of serious socially-significant ones. Among them miocardial infarction and stroke are the main problems in USA, Russia and Europe [3].

CVD risk management is a cyclic work of medical team. It consists of therapist     (personal treating doctor), nurse and doctors-consultants. In Russia we have a grate deficit of nurses in outpatient settings. In the case of risk realization doctors haven't official recommendation.

Existing dispanserisation system is a Russia's phenomenon of preventive activity on the population level. It is aimed to prevent fatal CVD and accompanying diseases, prevent invalidity.

Dispanserisation helps to fill the gap between clinical guidance and real clinical practice. In outpatient settings life style strategies will be more effective in patients of high and very high fatal CVD risk than in patients of low and intermediate risk.

In the CDC of the First Moscow State Medical University risk management algorithm was established on the dispanserisation base. It contains two moduls: CVD preventive activity and activity in the case of CVD risk realization.

CVD preventive activity in our outpatient setting can be divided into four steps.

1 A. Therapist interprets patient's medical narrative, constructive analyzes of complaints, concludes informed consent, develops the plan of treatment and researches.  What technical means cannot replace alive human dialogue and trust [1].

1 B. Consultants help with verification  diagnosis: ophthalmologist investigates eye fund, gynecologist recommends medications if climax syndrome, neurologist treats dizziness, andrologist corrects erectile dysfunction, endocrinologist help to treat metabolic syndrome, cardiologist makes treadmill test.   

1 С. Laboratory analyzes: HDLP-cholesterol, LDLP-cholesterol, Triglycerides, Total Cholesterol, Transaminases, Glucose.

1 D. Instrumental researches: ECG, Echocardiography, bi-functional ECG and blood pressure monitoring.

2 A. Therapist estimates initial CVD risk with European SCORE scale, recommends three-component preventive medicines, life style change. Today it is known from evidence-based medicine that anti-hypertensive, beta-blockers, anti-hyperlpidemic and acetylsalicylic acid prolong a life.

2 B. Psychotherapist recommend self-help. Peseschkian have proved that the most of CVD are psychosomatic diseases and will give in to treatment by the corporal-oriented methods of psychotherapy [2].

3.Therapist and a nurse control drug therapy by phone, e-mail, SMS.

4. Therapist estimates final risk and if necessary change the diagnosis and tactics of treatment.

 This cycle repeats till the realization of the risk. Then medical team must work as follow:

A. Therapist apologizes,  simpatizes, explains defects of sheduled medical aid (if they occurred).

B. If patient is non-satisfied, medical team’s leader apologizes,  simpatizes, explains defects of sheduled medical aid (if they occurred).

C. If patient is non-satisfied yet, the administrator in writing assures the patient that medical team worked in conformity with  standards. If defects have been admitted, administrator assures that guilty will discharged of work, will be directed on additional training.

D. If the patient brings an action ad win it, the outpatient setting administration pays the patient indemnification. For decrease in financial risks the insurance of professional responsibility of doctors in this case it is expedient. In the further patient continues preventive treatment (see CVD preventive activity algorithm).

For stable functioning system of CVD risk management it is necessary to spend monitoring of the critical control points.

1-3 steps. The doctor have a holistic image of his patient and can advocate his patient's rights, correctly write ambulatory card, the presence of signed informed consent in the card.

4. Reliability of distinction between initial and final CVD risk estimation is  the  main aim. The intermediate purposes the following: achievement of target levels of   HDLP-cholesterol, LDLP-cholesterol, Triglycerides, Transaminases, Glucose

In the Clinical – diagnostic Center of the First Moscow State Medical University was established such CVD risk management system. We selected 108 ambulatory cards of patients with iscemic heart disease and arterial hypertension. They where supervised by their doctors 3-5 years.   Control group consisted of 83 patients. They didn't conclude informed consent to dispanserisation. Average возраст in supervised and control group were 55,2±7,5 years old and 57,5±5,5 years old соответственно. Female were 60,5% in supervised group and 58,0% in control one.  We used метод непрямых разностей с учетом доверительного интервала. In the supervised group there were more patient of intermediate CVD risk: 55 vs 17 (p0,05), less patients of the very high risk: 5 vs 10 (p0,05), less patient of high risk: 20 vs 30 (p0,05). As the result of preventive activity patients transit from high and very high risk group into intermediate one more in the supervised group: 15 vs 3 (p0,05).

In conclusion we can resume that in the light of National project “The Health” dispanserisation of patients with CVD is considered as the cornerstone of Russia's healthcare system again.

 

Literature:

1.                   Дернер К. Хороший врач. Учебник основной позиции врача. - М.: Алтейя, 2006 — 470 с.

2.                   Пезешкиан Н. Психосоматика и позитивная психотерапия. Межкульттурные и междисциплинарные аспекты на примере 40 историй болезней. - М.: Институт позитивной психотерапии, 2006 — 254 с.

3.                   www. gks.ru