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Overcoming the tyranny of distance: An analysis of outreach visits to optimise secondary prevention of cardiovascular disease in high-risk individuals living in Central Australia

2015; Wiley; Volume: 24; Issue: 2 Linguagem: Inglês

10.1111/ajr.12222

1440-1584

Camilla S.L. Tuttle, M. Carrington, Simon Stewart, Alex Brown,

Health Promotion and Cardiovascular Prevention

Australian Journal of Rural HealthVolume 24, Issue 2 p. 99-105 Original Research Overcoming the tyranny of distance: An analysis of outreach visits to optimise secondary prevention of cardiovascular disease in high-risk individuals living in Central Australia Camilla S.L. Tuttle B.Biomed Sci, B.App Sci (Hons), PhD, Camilla S.L. Tuttle B.Biomed Sci, B.App Sci (Hons), PhD Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, AustraliaSearch for more papers by this authorMelinda J. Carrington BA, Postgrad Dip (Psych), PhD, Melinda J. Carrington BA, Postgrad Dip (Psych), PhD Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, AustraliaSearch for more papers by this authorSimon Stewart PhD, NFESC, FAHA, FCSANZ, Simon Stewart PhD, NFESC, FAHA, FCSANZ Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, AustraliaSearch for more papers by this authorAlex Brown B.Med, MPh, PhD, FCSANZ, FRACP, Corresponding Author Alex Brown B.Med, MPh, PhD, FCSANZ, FRACP Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaCorrespondence: Professor Alex Brown, Department of Aboriginal Health, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia. Email: [email protected]Search for more papers by this author Camilla S.L. Tuttle B.Biomed Sci, B.App Sci (Hons), PhD, Camilla S.L. Tuttle B.Biomed Sci, B.App Sci (Hons), PhD Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, AustraliaSearch for more papers by this authorMelinda J. Carrington BA, Postgrad Dip (Psych), PhD, Melinda J. Carrington BA, Postgrad Dip (Psych), PhD Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, AustraliaSearch for more papers by this authorSimon Stewart PhD, NFESC, FAHA, FCSANZ, Simon Stewart PhD, NFESC, FAHA, FCSANZ Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, AustraliaSearch for more papers by this authorAlex Brown B.Med, MPh, PhD, FCSANZ, FRACP, Corresponding Author Alex Brown B.Med, MPh, PhD, FCSANZ, FRACP Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaCorrespondence: Professor Alex Brown, Department of Aboriginal Health, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia. Email: [email protected]Search for more papers by this author First published: 19 August 2015 https://doi.org/10.1111/ajr.12222Citations: 5 Declaration of conflict of interest: There are no conflict interests. Trial registration: Australian New Zealand Clinical Trial Registry – ACTRN12614000284662. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Objectives We examined the logistical challenges of conducting an outreach, secondary prevention program for adults discharged from Alice Springs Hospital following an acute presentation of cardiovascular disease. Design and Setting This represents a sub-study of the Central Australian Heart Protection Study (CAHPS). Clinical, logistic and demographic data were used to examine the characteristics of outreach visits in the intervention arm of the study. Participants Fifty subjects initially allocated to the intervention arm of the trial were studied. Main outcome measures Completion of scheduled, plus additional outreach visits according to the intervention protocol. Results The majority of subjects presented with an acute coronary syndrome (44/50 (88%)) and 31 (62%) were of Indigenous ethnicity. However, Indigenous subjects being younger (53.1 ± 11.1 versus 58.0 ± 11.0 years non-Indigenous) had a more complex risk factor and co-morbid profile, with significantly more diabetes (77% versus 26% P < 0.001), hypertension (81% versus 53% P = 0.04) and renal failure (52% versus 21% P = 0.03). Community of origin of Indigenous subjects was 230 ± 208 km from the hospital versus 61 ± 150 km for non-Indigenous subjects (P = 0.004). Indigenous subjects missed a significantly higher number of scheduled visits at six months (1.39 ± 2.14 versus 0.16 ± 0.50 visits; P = 0.02). However, multivariate analyses suggested that distance did not influence successful completion of visits. Conclusions These early findings from CAHPS are invaluable to understanding and improving the feasibility of secondary prevention programs for Indigenous adults living with heart disease in remote communities. References 1Zhao Y, Dempsey K. Causes of inequality in life expectancy between Indigenous and non-Indigenous people in the Northern Territory, 1981–2000: a decomposition analysis. The Medical Journal of Australia 2006; 184: 490– 494. 2Ralph A, Jacups S, McGough K, McDonald M, Currie BJ. 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A pilot study of the feasibility of an Internet-based electronic Outpatient Cardiac Rehabilitation (eOCR) program in rural primary care. Heart, Lung & Circulation 2013; 22: 352– 359. Citing Literature Volume24, Issue2April 2016Pages 99-105 ReferencesRelatedInformation