Cardiorespiratory Outcomes Flashcards
What is a “patient pathway”?
The “best” route that a patient takes from their 1st contact with an NHS member of staff (usually GP), through referral, completion of treatment.
It also covers the period from entry into a hospital or a Treatment Centre, until the patient leaves
What are Zola’s Triggers to health-seeking? 5 points
- Interference with work / physical activity
- Interference with social relations
- Assigning arbitrary time limit
- Interpersonal crises (death, divorce)
- Sanctioning
State some barriers to health seeking? 6 points
- Inverse care law
- Geographical distance
- Previous bad experience
- Childcare issues
- Psychological factors (denial, worry, lack of education)
- Perception of symptoms as harmless
How can doctors reduce delay in patients getting help for their conditions? 3 points
- Community outreach programmes (Vs. central provision which is difficult to access)
- Transport (volunteer drivers)
- Quality improvement projects (Help think about system from user’s perspective)
What is the Inverse Care Law?
Availability of good medical care varies inversely with the need of the population served
What are the positives of making Performance Indicators publicly available? 4 points
- Increases information about healthcare provider
- Informs patient and encourages choice (Caveat Emptor)
- Transparency increases trust with provider
- Quantitative, with clear numerical figures
What are the negatives of making Performance Indicators publicly available? 5 points
- No evidence patients actually use this information more so than clinicians
- Does not always give the full picture
- Can be subject to random variation
- Not always actionable
- Must be adjusted for confounding factors
Why do South Asians have the highest rates of CVD?
- Genetic susceptibility
- Inverse care law
- Lifestyle: Increased smoking, low fruit / veg consumption, low exercise levels
- Language barriers
- Reliance on folk medicine
What six risk factors are associated with CVD?
Hypertension Smoking Hypercholesterolaemia Diabetes Inactivity Overweight / Obesity
Give examples of two online aids used to calculate CVD risk?
QRISK2
JBS3
Discuss the Joint British Societies (JBS) 10-year CVD risk prediction chart
- Is widely accepted
- Based on Framingham cohort study data of 10,000 patients
- Found many factors are associated with increased risk of CHD, CVD, HF, PVD etc.
What is the role of risk calculators?
- Visual representation to patients (i.e. red = bad, green = good)
- Informs clinicians on who to treat
What is the BP target for patients under and over the age of 80?
Under 80: 140/90
Over 80: 150/90
What is the BP target for diabetics with and without end-organ damage?
With end-organ: 130/80
With no end-organ: 140/80
What medications can precipitate an asthma attack?
NSAIDs
Beta-blockers
