Vascular Health and Risk Management (Jun 2017)
Worksite-based cardiovascular risk screening and management: a feasibility study
Abstract
Raj Padwal,1 Mohammad Rashead,2 Jonathan Snider,2 Louise Morrin,2 Agnes Lehman,2 Norm RC Campbell3 1Department of Medicine, Alberta Diabetes Institute and Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, 2Cardiovascular Health and Stroke Strategic Clinical Network of Alberta Health Services, 3Department of Medicine, Community Health Sciences and Physiology and Pharmacology, O’Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada Background: Established cardiovascular risk factors are highly prevalent and contribute substantially to cardiovascular morbidity and mortality because they remain uncontrolled in many Canadians. Worksite-based cardiovascular risk factor screening and management represent a largely untapped strategy for optimizing risk factor control.Methods: In a 2-phase collaborative demonstration project between Alberta Health Services (AHS) and the Alberta Newsprint Company (ANC), ANC employees were offered cardiovascular risk factor screening and management. Screening was performed at the worksite by AHS nurses, who collected baseline history, performed automated blood pressure measurement and point-of-care testing for lipids and A1c, and calculated 10-year Framingham risk. Employees with a Framingham risk score of ≥10% and uncontrolled blood pressure, dyslipidemia, or smoking were offered 6 months of pharmacist case management to optimize their risk factor control.Results: In total, 87 of 190 (46%) employees volunteered to undergo cardiovascular risk factor screening. Mean age was 44.5±11.9 years, 73 (83.9%) were male, 14 (16.1%) had hypertension, 4 (4.6%) had diabetes, 12 (13.8%) were current smokers, and 9 (10%) had dyslipidemia. Of 36 employees with an estimated Framingham risk score of ≥10%, 21 (58%) agreed to receive case management and 15 (42%) attended baseline and 6-month follow-up case management visits. Statistically significant reductions in left arm systolic blood pressure (−8.0±12.4 mmHg; p=0.03) and triglyceride levels (−0.8±1.4 mmol/L; p=0.04) occurred following case management.Conclusion: These findings demonstrate the feasibility and usefulness of collaborative, worksite-based cardiovascular risk factor screening and management. Expansion of this type of partnership in a cost-effective manner is warranted. Keywords: blood pressure, dyslipidemia, smoking, pharmacist, worksite
