Tuesday, August 7, 2012

Improving Cardiovascular Risk

Medivision presents an excerpt from our 60 minute pharmacy education video Improving Cardiovascular Risk, featuring Sian Carr-Lopez PharmD. on the topic of Hypertension and Cardiovascular Risk. The full length film, along with many other medical education titles, is available on VHS or DVD from health-e-mall.com, and also includes Robert B. Supernaw, PharmD. and Mary J. Ferrill, PharmD. discussing the roles of hyperlipidemia, cholesterol medications and hypertension.

Hypertension is quantitatively the most important risk factor for premature cardiovascular disease; it is more common than other risk factors such as cigarette smoking, dyslipidemia, and diabetes. Hypertension accounts for an estimated 54 percent of all strokes and 47 percent of all ischemic heart disease events globally. Hypertension increases the risk for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral vascular disease. Coronary disease in men and stroke in women are the principal first cardiovascular events noted after hypertension onset, and in view of the evidence that the mortality rates are rising in younger people in the United States and the increasing impact of cardiovascular diseases in developing countries, greater attention must be given to prevention of these diseases. The increase in cardiovascular risk has primarily been described in terms of elevated systolic pressure in those over age 60 and elevation in diastolic pressure in younger individuals. Pulse pressure, which is the difference between the systolic and diastolic blood pressures and is determined primarily by large artery stiffness, is also a strong predictor of risk.

High concentrations of total and LDL cholesterol and low levels of high-density lipoprotein (HDL) cholesterol predict cardiovascular risk in both men and women. High triglyceride levels have been associated with greater risk in women only. The risk of cardiovascular disease increases by an average of 2% for each corresponding 1% rise in total cholesterol.

Clinical studies have shown that statins significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD), and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. While best known as drugs that lower cholesterol, statins have several other beneficial effects that may also improve cardiac risk, and that may turn out to be even more important than their cholesterol-reducing properties.

Thursday, August 2, 2012

Building Healthy Communities

Featuring Mary Totten; President, Totten and Associates, Ted Landsmark; President, Boston Architectural Center, and Philip Newbold, President and CEO of Memorial Health System.
This video is designed to assist community developers in gaining a better understanding of the assets and resources in your community. Learn how to create partnerships that makes the most effective use of your community's resources, understand the changing role of the board from community relations to community health, develop a community-focused mission and learn what boards can do to ensure effective involvement in community health and how to identify unmet needs in the community. The full length film, along with many other medical education titles, is available on VHS or DVD from health-e-mall.com

Many important initiatives to engage communities in addressing their health care crises are currently underway throughout the United States. National organizations are convening community dialogues and organizing consumer advocacy projects. Foundations and academic centers are identifying effective community strategies, analyzing the secrets of their success, and disseminating them as effective models and
approaches. State governments, many of which are dealing with significant budgetary shortfalls, are monitoring the creative initiatives of certain pioneering communities. In some regions, federal, state, and community stakeholders are working together to improve access and coverage.

Effective collaborations involve a process through which citizens, providers, advocates, government officials, and other stakeholders explore obstacles, differences and alternative strategies for improving access to health care.

Ingenuity and determination are behind efforts in communities that are successfully overcoming barriers to health care access. The models vary widely, but all involve diverse community partners who have come together and reached consensus on strategies. Virtually all the effective projects involve regular monitoring and cost/benefit analysis, projecting or demonstrating dramatic savings to local and regional economies.
Some have tackled the issue of coverage by creating local, nonprofit managed care plans for low-income
workers, other uninsured residents, or people living with chronic diseases. Among the most promising programs for future sustainability are those where financing involves cost sharing—in which employers, employees, government and community funders all contribute.

Other communities have addressed different elements of access. Volunteers and staff members may find
under served patients a “medical home.” Or they may facilitate patients’ enrollment in public programs,
ensure transportation to health care appointments, provide translation and interpretation services, or case-manage those with chronic and costly illnesses. Effective community collaborations usually enlist health care providers, social service agencies, pharmacies, and even insurance agents to donate or deeply discount their services to support the newly created systems.

The emphasis of community-based healthcare has been changing; among other aims, asset based working promotes well-being by building social capital, promoting face-to-face community networks, encouraging civic participation and citizen power. High levels of social capital are correlated with positive health outcomes, well-being and resilience.
Local government and health services face cuts in funding. Demographic and social changes such as an aging population and increasing unemployment mean that more people are going to be in need of help and support; new ways of working will be needed if inequalities in healthcare are not to get worse.

It’s important to assess your community’s strengths and assets as well as your needs, as is the ability to focus your efforts on policies and programs that build on your community’s existing assets and resources. Identifying these elements early will help you later as you choose effective policies & programs and begin to act on what’s important to implement policies and programs.

Social community assets involve the extent to which community residents interact with each other for the good of the community. This collective interaction may take the form of participating in community meetings, voting in local and national elections, and helping out with community problems like teen violence or wide-spread drug abuse. It also may involve community mobilization to advocate for projects that may further strengthen the community, such as increased funding for new community centers or after school programs.

Additional Information:
Improving Health Care Access: Finding Solutions in a Time of Crisis