Presentation on theme: "Health Promotion in Primary Care"— Presentation transcript:
1 Health Promotion in Primary Care Dr Lola Savage15th February 2012
2 AIM To increase awareness of health promotion in General practice Case presentationNHS health CheckQuestions-Single best Answer
3 GP CurriculumHealthy people: promoting health and preventing disease
4 DefinitionWHO: Health promotion is a process of enabling people to increase control over and to improve their health
5 PreventionHealth Professionals-we aim to prevent diseases in our patientsPrevention can be classified into the following:Primary preventionSecondary preventionTertiary preventionWhich of the above categories do we spend most of our time doing?
6 Primary preventionWhat health promotion activities do we currently advocate in primary care?
7 Primary Prevention New Patients Well woman and well man clinics ImmunisationsTravel adviceScreening programmes- cervical/mammogram/STI
8 New patients health check UrinalysisBMIBlood pressureSmoking statusExerciseAlcohol screen-Audit CFamily hxEthnicityHealth ed- diet/ exercise-recordedWell woman/men check:Smear status
9 How do we as GP registrars incorporate primary prevention into our practice?
10 How can we incorporate health promotion into our consultations Medication review-review summary records- alcohol intake/BMI/cholesterol/renal functionPill check-promote LARCAdhere to prompts for QOF- e.g smoking/ blood pressure readingPregnant patients-folic acid/blood pressure/alcohol/smoking/diet/vit D/refer to community midwife? Promote NHS health checks
11 Case Presentation53 man who presented with a 12 week history of Left foot pain following a car going over his foot in a motorcycle event. X-ray left foot-NADPMH- Essential HypertensionDHx-Amlodipine 5mg od (last issued may 2010)SHx- Runs his own company. Doesn’t smokeWhat should I do next?
12 Case PresentationTook brief hx of the pain/ex his left foot and decided to refer him for physiotherapyEstablish a rapport with him and explored his ideas about his medical hx and non compliance with medicationsClinic blood pressure readings: 174/85, 162/93
13 Case PresentationArrange for him to do home readings for a week and to review againAverage home readings-156/90Reviewed risk- bloods- cholesterol/renal function/glucoseQ-risk- 9.5%Nice guidelines- ACEI- ramiprilReviewed in 1/12- bp 130/86Follow up- pt applied for health insurance- declined-previous hx of non-compliance to meds
14 NHS health check Background Heart disease/ Stroke /Diabetes and kidney disease are the biggest cause of death in the UK4 million of people in the UK affected170,000 people die each year in England from these conditionsHealth inequalities in deprived areas and in certain ethnic groups2008-DoH published ‘Putting Prevention First’ –sets out a systematic and integrated approach to assess individuals between 40-74This National Screening Programme is known as Health Checks- due to be rolled out by PCTs in 2012/2013
15 NHS health checkInvites patients ages who are not known to have DM/CVD/TIA/ MI/HT once every 5 yearsFixed factors-Age/ Gender/Ethnicity
16 NHS health checksAimsTo identify patients at risk of developing MI/CVA/TIA/Diabetes/HTTo sustain increase in life expectancyTo reduce premature death associated with obesity/sedentary lifeReduce health inequalitiesReduce the cost of long term ill health on the NHS
20 1 Which of the following statements does not apply to the Cardiovascular Disease Screening Programme?a) Cardiovascular disease screening will identify risk factors that will contribute tovascular diseaseb) Early intervention can reduce the onset of vascular diseasec) Cardiovascular Disease screening will support patients who have had a heart attack.d) Cardiovascular Disease screening can prevent and in some circumstances reverse the onsetof vascular disease2 For what age group is the National Cardiovascular Disease screening programme recommended?a) 20yrs- 40yrsb) 30yrs- 64yrsc) 35yrs- 65yrsd) 40yrs- 74yrs3 Which of the following blood pressure measurements would you refer your client to their GP?a) 130/75b) 130/85c) 140/85d) Above 140/90
21 4 Which of the following risk factors can be modified or potentially reversed in the Cardiovascular Disease Screening process?a) Ageb) High Blood pressurec) Ethnicityd) Family History Cardiovascular disease5 Which of the following conditions will not affect a patient’s Cardiovascular Disease risk calculation?a) Smokingb) Elevated BPc) Diabetesd) AlcoholWhy would a 45 year old male who smokes, has a blood pressure of 160/90, Total Cholesterol/ HDL ratio of 6.0 and a BMI of 27.7 have a low CVD QRISK Risk Score of 8%?a) They drink above the recommended 21 units of alcohol per weekb) They have Asthmac) Because he is 45yrs oldd) Because he has Diabetes
22 7 Lifestyle advice/or referral as part of the NHS Health Check is important because…. a) Fresh air is good for everyoneb) It offers patients the opportunity to make lifestyle changes that will improve their healthc) It looks good for the practiced) The government thinks it’s a good idea.8 When should a patient be sent for a fasting blood glucose test for assessment of Diabetes through NHS Health Checks?a) BMI is in the obese range >30b) Blood pressure is at or above 140/90, or where the SBP or DBP exceeds 140 or 90respectively.c) The patient has a BMI >27.5 and is either Indian, Pakistani, Bangladeshi, Other Asian orChinesed) All the above
23 Summary Increase awareness of health promotion in primary practice Case presentationNHS health checks