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Excerpt
The long term monitoring of cardiac patients is frequently undertaken by local medical practitioners and not by the institution providing acute and rehabilitative care. The Shared Heart Care Program in Australia has used its resources in partnership with individual hospitals, academic institutions and the Heart Foundation as an opportunity to provide follow up at a number of levels.
The aim of this study was to evaluate the success of this program as a strategy for monitoring patient outcomes. Patients were asked to attend an assessment at the centre where their acute event was managed. At this assessment they were weighed, had their blood pressure, serum cholesterol and blood sugar measured and provided information about their risk factor status and medication use. Three hundred and sixty-six cardiac patients voluntarily attended appointments for review at five sites spread across three States in 1999. Mean time since acute cardiac event was 18.6 months. Mean age of the patients was 62.99 years (SD10.33). Sixty-four patients reported continuing to smoke, 65 were diabetic, 234 had a body mass index (BMI) greater than 25, total cholesterol was elevated above recommended levels in 239. Comparisons between those who had attended outpatient cardiac rehabilitation and those who had not attended showed a statistically significant association between attendance and non-smoking, (chi square = 32.39, df = 1, P < 0.0001). Mean total cholesterol was significantly lower in attenders compared to non-attenders (t = 2.32, df = 346, P = 0.02). Of the patients with elevated serum cholesterol, 41% were not on any prescribed medication and the remaining 51% had an inadequate dose. The Shared Heart Care program demonstrated the ability to assist in monitoring and coordinated care by providing outcome data relevant to individual patients, to cardiac program staff, and to medical practitioners as well as allowing benchmarking across institutions.
