Wide Variation in Absolute Cardiovascular Risk Assessment in Aboriginal and Torres Strait Islander People with Type 2 Diabetes

Overview

Journal Front Public Health

Specialty Public Health

Date 2016 Mar 26

PMID 27014674

Citations 7

Authors

Bhakti R Vasant

Veronica Matthews

Christopher P Burgess

Christine M Connors

Ross S Bailie

Affiliations

Soon will be listed here.

Abstract

Background: Absolute cardiovascular risk assessment (CVRA) is based on the combined effects of multiple risk factors and can identify asymptomatic individuals at high risk of cardiovascular disease (CVD). Aboriginal and Torres Strait Islander people, the Indigenous people of Australia, are disproportionately affected by CVD and diabetes. Our study aimed to investigate variations in the use of absolute CVRA in patients with diabetes at Indigenous community healthcare centers and to identify patient and health center characteristics that may contribute to this variation.

Methods: Audits of clinical records of 1,728 patients with a known diagnosis of diabetes across 121 health centers in four Australian States/Territories [Northern Territory (NT), South Australia, Western Australia, and Queensland] over the period 2012-2014 were conducted as part of a large-scale continuous quality improvement program. Multilevel regression modeling was used to quantify variation in recording of CVRA attributable to health center and patient characteristics.

Results: The proportion of eligible patients with documented CVRA was 33% (n = 574/1,728). The majority (95%) of assessments were conducted in the NT. Multilevel regression analysis showed health center characteristics accounted for 70% of the variation in assessments in the NT. Government-operated health centers had 18.8 times the odds (95% CI 7.7-46.2) of recording CVRA delivery compared with other health centers.

Conclusion: Health centers in the NT delivered the majority of absolute CVRA to Indigenous patients with diabetes in our study. Health systems factors that may have facilitated provision of CVRA in the NT include decision support tools and a reporting process for CVRA delivery. Implementation of similar systems in other jurisdictions may help improve CVRA delivery. Early identification and treatment of high risk individuals through wider use of CVRA may help reduce the burden of CVD in Indigenous Australians with diabetes.

Citing Articles

Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health.

Conte K, Laycock A, Bailie J, Walke E, Onnis L, Feeney L Health Res Policy Syst. 2024; 22(1):3.

PMID: 38172892 PMC: 10765661. DOI: 10.1186/s12961-023-01087-2.

Absolute cardiovascular risk assessment by Australian early-career general practitioners: a cross-sectional study.

Morgan T, Ralston A, Davey A, Holliday E, Nelson M, Fielding A Fam Med Community Health. 2023; 11(3).

PMID: 37604595 PMC: 10445344. DOI: 10.1136/fmch-2023-002251.

Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia.

Diaz A, Vo B, Baade P, Matthews V, Nattabi B, Bailie J Int J Environ Res Public Health. 2019; 16(19).

PMID: 31569670 PMC: 6801551. DOI: 10.3390/ijerph16193630.

Implementation of continuous quality improvement in Aboriginal and Torres Strait Islander primary health care in Australia: a scoping systematic review.

Gardner K, Sibthorpe B, Chan M, Sargent G, Dowden M, McAullay D BMC Health Serv Res. 2018; 18(1):541.

PMID: 29996836 PMC: 6042325. DOI: 10.1186/s12913-018-3308-2.

Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

Bailie R, Matthews V, Larkins S, Thompson S, Burgess P, Weeramanthri T BMJ Open. 2017; 7(10):e016626.

PMID: 28982818 PMC: 5639983. DOI: 10.1136/bmjopen-2017-016626.

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