Premium
Feasibility and outcomes of screening for cardiovascular risk factors in the e mergency d epartment
Author(s) -
Tan Natalie,
Taylor David McDonald
Publication year - 2013
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12060
Subject(s) - medicine , referral , attendance , pediatrics , family medicine , economics , economic growth
Objectives The present study aimed to determine the prevalence of undiagnosed and undertreated hypercholesterolaemia and hypertension ( HT ) among ED patients and to evaluate the effects of a formal referral back to the general practitioner ( GP ) for further management. Methods This was a cross‐sectional study of ED patients with follow up, if indicated. Patients aged ≥35 years, without substantial illness or communication difficulties, were enrolled. Data were collected using a researcher‐administered questionnaire, a point‐of‐care A ccutrend® P lus System machine (Roche Diagnostic Australia Pty Ltd, Castle Hill, NSW, Australia) and digital sphygmomanometer. Patients with total cholesterol ( TC ) ≥6.0 mmol/L and/or BP ≥140/90 were given a referral letter and advised to consult their GP . The investigators made follow‐up telephone calls 5 weeks later. Results Of 827 presentations, 534 patients were enrolled (mean age 56.7 ± 13.3 years, 300 [56.2%] male). One hundred and eleven patients (20.7%, 95% CI 17.5–24.5) had TC ≥6.0 mmol/L. Patients with/without elevated TC differed significantly ( P < 0.05) in regard to age, gender, GP ownership and attendance, and previous screening. Sixty‐six patients consulted with their GP . Thirty had their TC levels retested, 18 received dietary/lifestyle advice and four had lipid‐lowering medication prescribed or adjusted. Ninety‐six patients (18.0%, 95% CI 14.9–21.6) had HT . Whereas 53 consulted their GP , no action was taken in 43 cases. Investigations were ordered for three and nine had antihypertensive medication prescribed or adjusted. Conclusion Substantial proportions of ED patients have undiagnosed and undertreated hypercholesterolaemia and/or HT . GP referral initiated interventions for many patients with hypercholesterolaemia, but fewer with HT . The ED has potential as a useful venue for the opportunistic screening of hypercholesterolaemia.