- Email: [email protected]
Community Assessment of Risk and Education for Atrial Fibrillation (Care-AF)
Abstracts
S329
risk assessment, 49% (n¼35835) of the individuals in the conditioned-reward group registered for the health e-Support service compared to only 5% (n¼3541) in the control group (p<0.001). A greater number of individuals in the conditionedreward group (12%) interacted with the e-Support program more than once compared to the Controls (9%), p0.05). CONCLUSION: Consumer rewards were effective in increasing participation in an internet-based health risk assessment and e-Support programs. However, the overall engagement level with the e-Support program remained low. Future studies need to examine the schedules of consumer reward reinforcement and key components of e-Support intervention design on engagement level and intervention efficacy.
evaluate the role of physical activity and programs such as Cardiac Rehabilitation towards AF prevention in at risk populations. The Framingham AF Risk Score should be considered for widespread use by primary health care as a tool for AF risk evaluation, patient education and risk factor modification in an effort to reduce a rapidly growing and very costly chronic disease. Dalhousie University Student Summer Research Program
607 COMMUNITY ASSESSMENT OF RISK AND EDUCATION FOR ATRIAL FIBRILLATION (CARE-AF)
Kingston, Ontario
A Hooda, N Giacomantonio Halifax, Nova Scotia INTRODUCTION:
Atrial Fibrillation (AF) is the most common chronic cardiac arrhythmia and major risk for thromboembolic events, heart failure and poor quality of life. Previous evidence suggests increasing AF incidence not just because of age but also because of rising modifiable risk factors. There is little prospective data on the future risk of developing AF. METHODS: We compared future AF risk between individuals participating in the 2012 Heartland Tour (HLT group www.HeartLandTour.ca) with the general population. We utilized a recently developed Framingham Model for short term -10 year- AF risk (FAF risk score) RESULTS: In 139 eligible participants of the HLT, the average FAF risk score was 2.63% compared to 6.83% in 169 members of the general population (p<0.001). Activity levels of the two groups were standardized using Godin-Shephard Leisure Time Exercise Score (GS score). Average HLT cohort score was 51.6 versus 30.0 for the general population (p<0.04). A GS score of 24 is associated with tangible health benefits. This was found in 193 study participants, and they had an accompanying FAF score of 3.73%. Those with a GS score of less than 24 had an average FAF score of 7.58%. After standardizing for cardiac risk factors including age, the difference in these FAF scores remained significant (p¼0.0146). CONCLUSION: To the best of our knowledge, this is the first study to quantitatively show that moderate physical activity may reduce the future risk of developing AF by as much as 50% and is the first study to prospectively utilize this FAF risk model in a population health community setting. Organized heath events as the HLT have the opportunity to reduce future AF risk and should be promoted and supported for this activity. However, we cannot exclude the possibility that such organized events have a selection bias towards more active and subsequently lower risk populations, which is defeatist of their stated objectives in motivating and changing behaviors of those at most risk. Further study is required to expand this assessment in other health-oriented events that promote physical activity and to prospectively
608 KNOWLEDGE AND IMPLEMENTATION OF CARDIOVASCULAR RISK SCORES BY FAMILY PHYSICIANS M Matangi, D Armstrong, J Niznick, R Del Grande, P Hollett, P De Young BACKGROUND: To determine the knowledge and implementation of the various cardiovascular risk scores (CVRS) available to a family doctor (FD) in South eastern Ontario. METHODS: The authors represent community cardiovascular specialists (CCS) in southeastern Ontario, Canada. FDs that refer to these CCS were contacted by FAX or letter and were first asked a series of questions of their knowledge of the various CVRS. A second set of questions were then asked as to what method(s) the FD actually used to assess cardiovascular risk and prescribe Statins. The questionnaire was anonymous and the FD was asked to indicate what they actually use to assess cardiovascular risk and not what they think they should be using. CVRS knowledge was classified as, 1. Any, 2. FRSC (Framingham risk score coronary), 3. FRSG (global), 4. Reynolds, 5. JUPITER or 6. ARIC. CVRS use was the same except counting risk factors to assess the need for a Statin was an option. RESULTS: One hundred and twenty of 231 (51.9%) family physicians contacted by FAX returned the questionnaire by FAX compared to only 61 of 500 (12.5%) contacted by letter. The total surveys returned were 181. The main results can be seen in the figure below. CONCLUSION: There is no knowledge deficit with respect to the FRS. There is a significant knowledge deficit in the CVRS requiring either hs-CRP (Reynolds risk score and JUPITER) or carotid imaging data (ARIC). What is apparent is that despite their knowledge of the FRS (coronary or global), 72% of FDs surveyed admitted that they still count risk factors when assessing the need for Statin therapy. We believe these results indicate that cardiovascular risk is likely being underestimated by FDs in southeastern Ontario and propose that since implementation appears to be the main problem a different strategy is required.
S329
risk assessment, 49% (n¼35835) of the individuals in the conditioned-reward group registered for the health e-Support service compared to only 5% (n¼3541) in the control group (p<0.001). A greater number of individuals in the conditionedreward group (12%) interacted with the e-Support program more than once compared to the Controls (9%), p0.05). CONCLUSION: Consumer rewards were effective in increasing participation in an internet-based health risk assessment and e-Support programs. However, the overall engagement level with the e-Support program remained low. Future studies need to examine the schedules of consumer reward reinforcement and key components of e-Support intervention design on engagement level and intervention efficacy.
evaluate the role of physical activity and programs such as Cardiac Rehabilitation towards AF prevention in at risk populations. The Framingham AF Risk Score should be considered for widespread use by primary health care as a tool for AF risk evaluation, patient education and risk factor modification in an effort to reduce a rapidly growing and very costly chronic disease. Dalhousie University Student Summer Research Program
607 COMMUNITY ASSESSMENT OF RISK AND EDUCATION FOR ATRIAL FIBRILLATION (CARE-AF)
Kingston, Ontario
A Hooda, N Giacomantonio Halifax, Nova Scotia INTRODUCTION:
Atrial Fibrillation (AF) is the most common chronic cardiac arrhythmia and major risk for thromboembolic events, heart failure and poor quality of life. Previous evidence suggests increasing AF incidence not just because of age but also because of rising modifiable risk factors. There is little prospective data on the future risk of developing AF. METHODS: We compared future AF risk between individuals participating in the 2012 Heartland Tour (HLT group www.HeartLandTour.ca) with the general population. We utilized a recently developed Framingham Model for short term -10 year- AF risk (FAF risk score) RESULTS: In 139 eligible participants of the HLT, the average FAF risk score was 2.63% compared to 6.83% in 169 members of the general population (p<0.001). Activity levels of the two groups were standardized using Godin-Shephard Leisure Time Exercise Score (GS score). Average HLT cohort score was 51.6 versus 30.0 for the general population (p<0.04). A GS score of 24 is associated with tangible health benefits. This was found in 193 study participants, and they had an accompanying FAF score of 3.73%. Those with a GS score of less than 24 had an average FAF score of 7.58%. After standardizing for cardiac risk factors including age, the difference in these FAF scores remained significant (p¼0.0146). CONCLUSION: To the best of our knowledge, this is the first study to quantitatively show that moderate physical activity may reduce the future risk of developing AF by as much as 50% and is the first study to prospectively utilize this FAF risk model in a population health community setting. Organized heath events as the HLT have the opportunity to reduce future AF risk and should be promoted and supported for this activity. However, we cannot exclude the possibility that such organized events have a selection bias towards more active and subsequently lower risk populations, which is defeatist of their stated objectives in motivating and changing behaviors of those at most risk. Further study is required to expand this assessment in other health-oriented events that promote physical activity and to prospectively
608 KNOWLEDGE AND IMPLEMENTATION OF CARDIOVASCULAR RISK SCORES BY FAMILY PHYSICIANS M Matangi, D Armstrong, J Niznick, R Del Grande, P Hollett, P De Young BACKGROUND: To determine the knowledge and implementation of the various cardiovascular risk scores (CVRS) available to a family doctor (FD) in South eastern Ontario. METHODS: The authors represent community cardiovascular specialists (CCS) in southeastern Ontario, Canada. FDs that refer to these CCS were contacted by FAX or letter and were first asked a series of questions of their knowledge of the various CVRS. A second set of questions were then asked as to what method(s) the FD actually used to assess cardiovascular risk and prescribe Statins. The questionnaire was anonymous and the FD was asked to indicate what they actually use to assess cardiovascular risk and not what they think they should be using. CVRS knowledge was classified as, 1. Any, 2. FRSC (Framingham risk score coronary), 3. FRSG (global), 4. Reynolds, 5. JUPITER or 6. ARIC. CVRS use was the same except counting risk factors to assess the need for a Statin was an option. RESULTS: One hundred and twenty of 231 (51.9%) family physicians contacted by FAX returned the questionnaire by FAX compared to only 61 of 500 (12.5%) contacted by letter. The total surveys returned were 181. The main results can be seen in the figure below. CONCLUSION: There is no knowledge deficit with respect to the FRS. There is a significant knowledge deficit in the CVRS requiring either hs-CRP (Reynolds risk score and JUPITER) or carotid imaging data (ARIC). What is apparent is that despite their knowledge of the FRS (coronary or global), 72% of FDs surveyed admitted that they still count risk factors when assessing the need for Statin therapy. We believe these results indicate that cardiovascular risk is likely being underestimated by FDs in southeastern Ontario and propose that since implementation appears to be the main problem a different strategy is required.