Identification Cardiovascular Disease Online Tutoring

Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service
Summary

The article under consideration is “Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service” by Burgess et al. (2011). Cardiovascular disease causes for high mortality rates among Aboriginal and Torres Strait Islander Australians. The main idea of the current article is to define whether the assessment of the risks of the development of cardiovascular diseases while Adult Health Check among Aboriginal adults in a remote Australian area can help identify elevated cardiovascular disease risks better, improve the preventive measures for cardiovascular diseases, and advance cardiovascular disease risk profile. The article conducts and longitudinal research among Aboriginal and Torres Strait Islander Australians involving qualitative and quantitative research designs for data analysis and interpretation, aimed at helping drawing the relevant conclusions.

Methodology

The research was conducted in Arnhem Land community in Australia’s Northern Territory. Initially, the researchers conducted the preliminary evaluation having studied the clinic records of 440 non-perinatal deaths in this community for over 25 years. The indicated finding (25% of deaths from overall sample and 33% of deaths among people aged 15-54 resulted from cardiovascular diseases) have allowed the researchers to draw the conclusion about the high rates of cardiovascular diseases among Aboriginal and Torres Strait Islander Australians and initiate the new research. The preliminary evaluation was a good beginning showing the need for studying the problem with the purpose to reduce the death rates from cardiovascular diseases.
In 2005, the general practitioners initiated the Adult Health Check in the community, which was launched by the Australian Government in 2004 “to encourage early detection, diagnosis and intervention for common and treatable conditions that cause considerable morbidity and early mortality” (Commonwealth of Australia, 2010). The general practitioners evaluated the health condition of 301 subjects each six month for three years before the intervention. The Adult Health Check was the intervention the practitioners did in three years after the beginning of monitoring subjects’ health. After the intervention, the researchers followed the subjects for three years. The findings were evaluated by means of qualitative data analysis, where the information helped obtain the results about the cardiovascular disease preventive care, medications prescribed to the patients with cardiovascular risks, primary health care consultations, and other aspects identified while the study. Moreover, chi square, t-tests, McNemar’s test, Cohen’s Kappa statistic, and ANOVA tests were used to conduct the statistical analyses of the data and identify the measures in numerical perspective.
The methodology has allowed the researchers to assess the health condition of the subjects before the intervention. Then, they conducted a research itself having made the Adult Health Check of the patients. Further, they followed those for three years. Such a strategy has appeared to be effective in showing the changes in subjects’ health. The use of longitudinal research is beneficial for nursing studies because it allowed identifying the sequence of events, which will further help in drawing contribution action for health prevention (Caruana, Roman, Hernández-Sánchez, & Solli, 2015). Thus, the choice of the researchers perfectly met the research objectives and predicted outcomes.

Results

The researchers indicated that 25% of the subjects had elevated cardiovascular disease risk. They had to exclude 11 participants because they left the community. Only 58 participants completed standardized post- Adult Health Check clinical review. The results have indicated the increase in the cardiovascular diseases preventive measures. The intervention has also raised the number of cardiovascular disease treatment related medication. The expected absolute cardiovascular disease risks lowered by 20% in ten years after intervention compared to the predicted amount in case of no intervention. The findings have clearly shown how the intervention (Adult Health Check) has contributed to the reduction of the risks of cardiovascular disease development. The findings in the article were grouped according to the themes and described with scrupulous and detail.

Limitation

No clinical outcomes were obtained throughout the time series due to the lack of 80% complete data at each time interval. The mean number of the cardiovascular diseases events did not change, which negatively contributed to the generalization of the findings. Kucharska‐Newton et al. (2017) have conducted a research with changed events before and after intervention and their findings were more beneficial for analyzing the effectiveness of the preventive measures. The involvement of the primary researcher in all stages of the study is also a limitation, which could impact the bias (Smith & Noble, 2014).

Implications

The findings of the current research can be used in any remote area where the mortality from the cardiovascular diseases is high. The application of the Adult Health Check at the early stages and the prediction and prevention of the possible complications can help reduce the future disease development. Remote areas are always a problem for disease prevention and identification. This study has shown the rate of mortality from cardiovascular diseases can be reduced in Australia. However, the number of limitations cannot guarantee the effective outcomes in other areas due to the lack of interest of the nurses and inability to follow precisely their adherence to the prescriptions and on time Adult Health Check. The study can be applied both in practice and in theoretical research as the background information or the pilot study for further research with larger sample.

Conclusion

Therefore, the research is a good contribution to the reduction of the mortality rates from the cardiovascular diseases and the prevention of the disease development. Being conducted seven years ago with the substantial following the subjects, the new study can be initiated in different remote areas (for comparison of the outcomes) without excessive following each patient. The information from the current study has already assisted a number of patients, who have managed to prevent cardiovascular diseases and/or reduced the severity of the consequences. The researchers studied the sample for several years, which is a strong side of their study. Having applied a number of tests and designs to obtain the results, the study has drawn important conclusions about the effectiveness of Adult Health Check in reducing the mortality from the cardiovascular disease for remote areas.

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References

Burgess, C. P. Bailie, R. S., Connors, C. M., Chenhall, R. D., McDermott, R. A., O’Dea, K., … Esterman, A. J. (2011). Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service. BMC Health Services Research, 11(24), 1-11.
Caruana, E. J., Roman, M., Hernández-Sánchez, J., & Solli, P. (2015). Longitudinal studies. Journal of Thoracic Disease, 7(11), E537–E540.
Commonwealth of Australia. (2010). Medicare benefits schedule – Note A34. Australian Government Department of Health. Retrieved from http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=A34&qt=NoteID
Kucharska‐Newton, A., Griswold, M., Yao, Z. H., Foraker, R., Rose, K., Rosamond, W., … Windham, B. G. (2017). Cardiovascular disease and patterns of change in functional status over 15 years: Findings from the atherosclerosis risk in communities (ARIC) study. Journal of the American Heart Association, 6(3), e004144.
Smith, J., & Noble, H. (2014). Bias in research. Evidence-Based Nursing, 17(4), 100-101.

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