Assessing Māori/non-Māori differences in cardiovascular disease risk and risk management in routine primary care practice using web-based clinical decision support: (PREDICT CVD-2)

Authors

Tania Riddell
Rod T. Jackson
Susan Wells
Joanna Broad
L. Bannink

Year of Publication

2007

Source

The New Zealand Medical Journal, 120(1250)

Publication Type

Journal article (peer reviewed)

Publication Status

Completed

Abstract

The aim of this study was to describe the cardiovascular disease risk factor status and risk management of Māori compared with non-Māori patients opportunistically assessed in routine practice using PREDICT-CVD, an electronic clinical decision support programme. In August 2002, a primary healthcare organisation, ProCare, implemented PREDICT-CVD as an opportunistic cardiovascular risk assessment and management programme. Between 2002 and February 2006, over 20,000 cardiovascular risk assessments were undertaken on Māori and non-Māori patients. Baseline risk assessments were completed for 1450 (7%) Māori patients and 19,164 (93%) non-Māori patients. On average, Māori were risk assessed 3 years younger than non-Māori. Māori patients were three times more likely to be smokers, had higher blood pressure and TC/HDL levels ,and twice the prevalence of diabetes and history of cardiovascular disease as non-Māori. Among patients with a personal history of cardiovascular disease, Māori were more likely than non-Māori to receive anticoagulants, blood pressure-lowering and lipid-lowering medications. However, of those patients with a history of ischaemic heart disease, Māori were only half as likely as non-Māori to have had a revascularisation procedure. The authors conclude that an electronic decision support programme can be used to systematically generate cardiovascular disease risk burden and risk management data for Māori and non-Māori populations in routine clinical practice in real-time. Initial findings suggest that Māori are more likely than non-Māori to receive drug-based cardiovascular risk management if they have a personal history of cardiovascular disease. In contrast, among the subgroup of patients with a history of ischaemic heart disease, Māori appear to receive significantly fewer revascularisations than non-Māori.

Type of Study

Quantitative, Analysis

How to Access

Available free online at http://www.nzma.org.nz/journal/120-1250/2445/