This is a demonstration project using the Pfizer-Parke Davis “Close to the Heart” patient education program among high risk patients in VISN 20 (VA Northwest Network) in an effort to promote healthier lifestyles and behavior change among high risk patients.
In August 2003, 2000 high risk patients, with both diabetes and ischemic heart disease (IHD), were selected through the VISN 20 Data Warehouse. We extracted data from the VISN 20 Data Warehouse for one year prior to 5/31/03, for baseline data, and 2/28/04 for the patients that remained in this cohort for the 6 month follow-up survey. Patients received bulletins on a monthly basis for one year. Included with the bulletins were self-help tools for patients to self-manage their cholesterol and medications. At baseline, 415 patients who agreed to participate in the program completed three surveys: SF-12, Seattle Angina Questionnaire (SAQ), and a Risk Factor Survey.
For the 6 month follow-up data, 245 patients completed all three surveys (58%). Three quarters of the patients had hypertension and 21% had a history of congestive heart failure. Only 7% were of normal weight and at least 66% were either overweight or obese. Guideline medication use was unchanged from baseline with three-quarters of patients prescribed lipid lowering agents and beta blockers and 69% taking ACE Inhibitors. Fewer patients, however, had a BP >140/90 within this period of time, compared to baseline. More patients report exercising than at baseline and fewer patients report current smoking. 50% of patients thought that the monthly bulletins were helping them change their diet, 28% of patients thought that they were helping them increase the amount of exercise they do, and 78% of patients believed that the bulletins were helping them take their medications as prescribed by their provider. Patient response to the program appeared positive, and there were indications that there were moderate changes in risk behavior among those patients.
A patient education program that provides patients with information that they need to change their behavior seems to make moderate changes in risk behavior. 12 month data analysis is currently underway to determine the full effects of this program.