- Email: [email protected]
PW267 Australian Secondary Prevention Alliance: Health advocacy through unity
POSTER ABSTRACTS
Results: Of 5998 patients who survived their index admission 66% were male, with index admissions being 75% coronary disease, 19% stroke, 6% vascular disease. There were 33349 all-cause readmissions. Twenty-two per cent of patients (n¼1343) did not experience any readmissions (for ATD or other cause) in the two years following an ATD admission. Index admission and ATD related readmission costs together comprise 54% the total hospital costs for this group (47-60%; Figure 1). Two per cent of patients (n¼141) had chronic kidney disease and experienced 16668 dialysis admissions. A primary diagnosis of ATD accounted for 11% of readmissions at 24 months. There were 1352 (4%) admissions for rehabilitation in 842 patients and 702 (2%) admissions with a primary diagnosis of chest pain in 502 people. Twenty-seven per cent of patients (n¼1629) had a history of diabetes at index, of these 336 had a diabetes-related readmission. Another 17 patients without history of diabetes at index had a readmission for diabetes.
two years (174 were in-hospital fatal index cases). By two years there were 4586 ATDrelated readmissions. Sixty per cent of patients experienced no ATD-related readmissions, 23% experienced one, and 17% 2. Seventy-eight per cent of the 2-year ATD-related admission costs occurred within 90 days (ranging from 76% to 82% across the age span; Figure 1). Overall mean (SD) index admission cost was $9166 ($10941). Mean ATD-related readmission costs were: index to 90 days $2862 ($7850), 90 days to 12 months $1907 ($6834), and 12 to 24 months $1449 ($5902). Mean 90 day ATD-related costs was significantly higher (p<0.05) in males aged 55-69 years and males aged 70-84 years compared to males aged 35-54 years. Compared to women, men have significantly higher mean ATD-related admission costs for each follow-up time period (p<0.05). Conclusion: In a cohort hospitalised with ATD the associated 2-year cost to the health system, including index admission, was $95 million, with 40% of the study sample contributing at least one related readmission. The costs of ATD-related rehospitalisation within 90 days of the index admission are substantial, across age and sex categories. The higher bundled ATD cost in middle-aged men requires further investigation. Disclosure of Interest: None Declared PW266 Mobile Phones: Hope or Hype? A Qualitative Study of Best Practices in m-Health Development in a Low Income Country Dhruv S. Kazi*1,2,3, Pronoy Saha4, Nimi Mastey5 1 Medicine/Cardiology, San Francisco General Hospital, 2Medicine, 3Epidemiology and Biostatistics, University of California San Francisco, 4Health Technology Forum, San Francisco, 5 Stanford University School of Medicine, Stanford, United States
Conclusion: Seventy-eight per cent of patients return to hospital within two years of an ATD admission. Other admissions make up a significant proportion of the total hospital costs. Men aged 55-69 years had the highest ATD-related and total costs in the two years following an ATD admission. Rehabilitation and chest pain are the most frequent reasons for re-hospitalisation in those without kidney disease. Disclosure of Interest: None Declared PW265 Two-year hospital costs for atherothrombotic disease and related readmissions by age and sex Emily Atkins*1, Elizabeth Geelhoed1, Matthew Knuiman1, Tom Briffa1 1 School of Population Health, University of Western Australia, Perth, Australia Introduction: Hospitalisation for atherothrombotic disease (ATD) is associated with very low in-hospital death but high risk of readmission. The cost to the health system both in profile of readmissions and proximity to the index admission is poorly characterised. Objectives: To investigate the cost to the health system for an index hospitalisation with ATD and related readmissions at 90 days, 12, and 24 months by age and sex. Methods: All men and women aged 35-84 years admitted to a Western Australian tertiary public hospital in 2007 with a primary discharge diagnosis of ATD according to the International Classification of Disease version-10 Australian Modification were identified. Person-level linked hospital morbidity and mortality data over 2 years was obtained for each ATD case. Costs for the index admission and re-admissions were taken from Diagnostic Related Group codes and converted to 2013 Australian dollars using national health index deflators. Results: The 2007 sample included 6172 ATD patients (65% male; 74% coronary disease, 20% stroke, 6% peripheral vascular disease). A total of 783 (13%) died within
Introduction: m-health, or mobile phone-based technology in healthcare, is touted as a cost-effective solution to expand access and improve outcomes in low-resource settings. Despite the proliferation of software applications (“apps”), best practices in app development, particularly in low- and middle-income countries, remain uncertain. Objectives: To define best practices in the design, development, and field-testing of healthcare apps in a resource-scarce setting, in order to optimize usability and uptake. Methods: We conducted a qualitative study involving detailed interviews with stakeholders in the healthcare ecosystem, including patients, nurses, physicians, administrators, information technology staff, engineers, and software developers in hospitaland community-based settings in Mysore and Bangalore, India (n ¼ 130). We used prototypes (mock-ups or partially functional software) to elicit user preferences and to define development priorities. Inputs obtained from stakeholders were quickly incorporated into the next iteration of prototypes, and the process was repeated (“rapid prototyping”). Results: Stakeholders had a favorable view of mobile technology-based solutions for healthcare, but less than half had used a healthcare app prior to the interview. Despite higher marginal costs, patients strongly preferred voice-based solutions to text-based solutions because of limited literacy and numeracy, and unavailability of Indian-language phones. Providers preferred versatile apps that were accessible from a variety of devices (e.g., desktops, tablets, and phones); responsive web-based solutions that were platform-agnostic therefore outperformed native mobile solutions (e.g., Android or iOS clients) except in settings with limited internet connectivity. Drop-down fields produced significantly fewer errors and were faster than free-text entry. In projects involving low-literacy users or international collaborators, clarification of the syntax for error-prone fields significantly reduced user error and improved efficiency, e.g., dates (MM/DD/YYYY vs. DD/MM/YYYY), phone numbers (e.g., with or without preceding area code), and numerical inputs involving decimals (e.g., lab results). Data encryption and role-based password authentication were acceptable solutions for data security. Conclusion: Agile development practices involving rapid, iterative prototyping, and early, frequent engagement of patients and providers can yield valuable insights in the design and uptake of scalable m-health solutions. Disclosure of Interest: None Declared PW267 Australian Secondary Prevention Alliance: Health advocacy through unity Julie Redfern*1, Katherine Gall1, Clara Chow1,2, Secondary Prevention Alliance (Australia) 1 Cardiovascular Division, The George Institute; University of Sydney, 2Cardiology Department, Westmead Hospital, Sydney, Australia Introduction: Heart disease accounts for greater morbidity in Australia than any other disease state and 20% of deaths. Without a paradigm shift in the delivery of preventive services the number of individuals dying of repeat heart attacks is expected to double. Objectives: To describe the process, formation and structure of an Australian Alliance aimed at achieving advocacy and better delivery of secondary prevention services across Australia. Ultimately, the purpose is to describe an Australian plan for improving achievement of cardiovascular risk targets. Methods: To determine goals and identify organisations, a National consensus meeting of 40 participants representing Australian government and non-government agencies, consumers, health professionals (cardiology, primary care, nursing, allied health) and other key opinion leaders was convened. Feedback from discussions and surveys highlighted the need for formation of a National Alliance. Through a process of further surveys and stakeholder analysis an alliance was formed. An iterative and collaborative
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March, 2014
j
POSTER/2014 WCC Posters
PW269 Modifying the Morisky Medication Adherence Scale by Adapting Two Items from the Brief Medication Questionnaire to Fit Assessing the Overall Adherence to Polypharmacy Regimen of Cardiac Patients
million women have GDM. However there is a huge shortage of trained physicians in India. Objectives: To address this need, a comprehensive high end training initiative in the form of Certificate Course in Gestational Diabetes Mellitus (CCGDM) is required for Physicians. Methods: An innovative and strategic partnership was established between Public Health Foundation of India (PHFI) and Dr. Mohan’s Diabetes Educational Academy (DMDEA), to train primary care physician, Obstetricians and Gynecologist on GDM by updated contents covering majority of salient aspects of GDM prevention, screening and management. Results: This uniquely designed program is aimed to train 1460 Primary Care Physicians, Obstetricians and Gynecologists of India in 55 Regional Centers, across India covering 16 states, 1 Union Territory and 39 cities with the backbone of 15 National Experts, 110 Regional Faculty and 25 Observers. The regional training centers serve as practice oriented skill enhancement centers and professional networking hubs. Sessions on GDM is conducted only on Sunday once a month for 4 consecutive months by regional faculty through use of standardized teaching material following standard operating procedures PAN India. Each center consist of dual expert i.e. Diabetologist/Endocrinologist and Gyn/Obst, each who act as Regional Faculty. National faculty empanelled across the country appraised the regional faculty on course curriculum and other modalities of the course. Educational material developed for program is latest, context specific, content and resource sensitive. Quality assurance of the educational program is ensured by necessary documentation, peer-reviews and by establishing alignment between module objectives, lectures material, case discussions, assignments & assessments. The educational grant for the program has been provided by Johnson & Johnson Medical India.
Ali Y. Nori*1, Muhamad S. A. K. Ali2, Baharudin Ibrahim1, Rahmat Awang3, M. Azmi Hassali1 School of Pharmaceutical Sciences, Universiti Sains Malaysia, 2Department of Cardiology, Hospital Pulau Penang, 3WHO Collaborative Center of Tobacco Control, Universiti Sains Malaysia, Penang Island, Malaysia
1
Introduction: Heart disease maintains being the leading cause of premature death in Malaysia. Careful follow up for cardiac patients is crucial to consistently optimize treatment and monitor the therapeutic plan. Although the term adherence is found in the Malaysian medical records, there is no standard method used in measuring compliance with the prescribed medications. However the Morisky Medication Adherence Scale (MMAS) is widely used in governmental hospitals, it is not accurately implemented when dealing with polypharmacy regimens. Objectives: This study aimed to evaluate the applicability and reliability of a modified version of MMAS after replacing two items of “medication discontinuation” and “medication missing” with a similar items adapted from the Brief Medication Questionnaire to establish a general measure of adherence to the multiple medications of cardiovascular disease (CVD). Methods: A pilot phase included 22 cardiac patients was run to demonstrate face validity for the modified MMAS as well as to improve the translation to the Malaysian language. Thereafter, 174 patients were surveyed where the original MMAS was administered before the modified extra two items along with other questions about demographics and barriers to adherence. The patients were categorized according to their diagnosis into: coronary heart disease, arrhythmias, heart failure, congenital heart disease, and valvular heart disease groups. Results: The mean age of the sample was 55 years (10.25), 80.6% were males, 46.9% were ethnically Chinese, monthly median income was z 330$ (1050 RM) and 81.1% were not current smokers. The mean number of daily CVD medications per patient was 5. Only 65.7% of the respondents had correctly taken the medications according to the prescribed instructions, whereas 73.7% had failed to name all their medications. 25.1% had a history of medication discontinue without doctor’s order. The internal consistency (Cronbach’s alpha reliability) of the original and modified MMAS were 0.583 and 0.588 a respectively. Significant Item-total correlation (P <0.01) and between both versions (0.898; P <0.01) manifests concurrent validity for the newly modified MMAS in addition to the retaining of the dimensional structure of a single-factor scale confirmed by factor analysis. Conclusion: Although the psychometric properties of both scales are similar, it is advised to use the modified MMAS to assess adherence to multiple drug therapy (polypharmacy) and get a clear picture about medication discontinuation behaviour. Disclosure of Interest: None Declared PW271 Implementation of educational training program in Gestational Diabetes Mellitus Management for obstetricians / gynecologist and primary care physicians in India Sourabh K. Sinha*1, Sandeep Bhalla1, V. Mohan2, Ranjit Unnikrishnan3, Pratibha Karnad4, K. S. Reddy5, D. Prabhakaran6 1 Training, Public Health Foundation of India, New Delhi, 2Chairman, 3Vice Chairman, Dr Mohans Diabetes Education Academy, Chennai, 4Education, Johnson & Johnson Medical India, Mumbai, 5Administration, Public health foundation of India, 6Executive Director, Centre for Chronic Disease Control, New Delhi, India Introduction: Given the global scenario around 366 million people suffering from diabetes in 2011, which is expected to rise to a total of 552 million by 2030. India alone has 62.4 million people with diabetes and 77.2 million people with pre-diabetes as of year 2011. GDM affects up to 15% of pregnant women worldwide and in India estimated 4
GHEART Vol 9/1S/2014
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POSTER/2014 WCC Posters
Conclusion: GDM program is an effort to build capacity among primary care physicians, gynecologist & obstetricians in Gestational Diabetes Mellitus Management. This unique and sustainable initiative hopefully serve as a trend setter in the field of diabetes education and help improve maternal and child health indices in India. Disclosure of Interest: None Declared
PW272 Role of nursing staffs as primary care givers in Management of Non Communicable Diseases with focus in Diabetes Mellitus in Rural India Utplakshi Kaushik*1, Sourabh K. Sinha2 1 Sneh, Family Health International, 2Training, Public Health Foundation of India, New Delhi, India
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POSTER ABSTRACTS
process of literature review and consensus (May-Aug 2013) led to establishment of agreed goals and key messages. An Advisory Council for individual input was also formed and the Australian Federal Government and policy-makers were successfully engaged. Communication is via teleconference, face-to-face workshops and electronic means. Results: The Secondary Prevention Alliance (Australia) was established (May 2013) with representatives from 19 national organisations. These include government and non-government stakeholders, professional organisations, consumers and the Heart Foundation. The Advisory Council consists of 149 individuals and experts from Australia, New Zealand, Europe and Canada with a variety of expertise in clinical roles (43%), education/ research (31%), health management (19%) and government (7%). The Alliance has already facilitated increased awareness of secondary prevention and has engaged media and government relations. The alliance also allows consensus on national models of care and indicators. Conclusion: The National Secondary Prevention Alliance has united stakeholders with the common goal of raising the profile of the need for improved health care services in Australia. The process provides an example of how national unity and common messages facilitates advocacy. Disclosure of Interest: J. Redfern Grant/research support from: AZ Educational Grant, K. Gall Grant/research support from: AZ Educational Grant, C. Chow Grant/research support from: AZ Educational Grant
Results: Of 5998 patients who survived their index admission 66% were male, with index admissions being 75% coronary disease, 19% stroke, 6% vascular disease. There were 33349 all-cause readmissions. Twenty-two per cent of patients (n¼1343) did not experience any readmissions (for ATD or other cause) in the two years following an ATD admission. Index admission and ATD related readmission costs together comprise 54% the total hospital costs for this group (47-60%; Figure 1). Two per cent of patients (n¼141) had chronic kidney disease and experienced 16668 dialysis admissions. A primary diagnosis of ATD accounted for 11% of readmissions at 24 months. There were 1352 (4%) admissions for rehabilitation in 842 patients and 702 (2%) admissions with a primary diagnosis of chest pain in 502 people. Twenty-seven per cent of patients (n¼1629) had a history of diabetes at index, of these 336 had a diabetes-related readmission. Another 17 patients without history of diabetes at index had a readmission for diabetes.
two years (174 were in-hospital fatal index cases). By two years there were 4586 ATDrelated readmissions. Sixty per cent of patients experienced no ATD-related readmissions, 23% experienced one, and 17% 2. Seventy-eight per cent of the 2-year ATD-related admission costs occurred within 90 days (ranging from 76% to 82% across the age span; Figure 1). Overall mean (SD) index admission cost was $9166 ($10941). Mean ATD-related readmission costs were: index to 90 days $2862 ($7850), 90 days to 12 months $1907 ($6834), and 12 to 24 months $1449 ($5902). Mean 90 day ATD-related costs was significantly higher (p<0.05) in males aged 55-69 years and males aged 70-84 years compared to males aged 35-54 years. Compared to women, men have significantly higher mean ATD-related admission costs for each follow-up time period (p<0.05). Conclusion: In a cohort hospitalised with ATD the associated 2-year cost to the health system, including index admission, was $95 million, with 40% of the study sample contributing at least one related readmission. The costs of ATD-related rehospitalisation within 90 days of the index admission are substantial, across age and sex categories. The higher bundled ATD cost in middle-aged men requires further investigation. Disclosure of Interest: None Declared PW266 Mobile Phones: Hope or Hype? A Qualitative Study of Best Practices in m-Health Development in a Low Income Country Dhruv S. Kazi*1,2,3, Pronoy Saha4, Nimi Mastey5 1 Medicine/Cardiology, San Francisco General Hospital, 2Medicine, 3Epidemiology and Biostatistics, University of California San Francisco, 4Health Technology Forum, San Francisco, 5 Stanford University School of Medicine, Stanford, United States
Conclusion: Seventy-eight per cent of patients return to hospital within two years of an ATD admission. Other admissions make up a significant proportion of the total hospital costs. Men aged 55-69 years had the highest ATD-related and total costs in the two years following an ATD admission. Rehabilitation and chest pain are the most frequent reasons for re-hospitalisation in those without kidney disease. Disclosure of Interest: None Declared PW265 Two-year hospital costs for atherothrombotic disease and related readmissions by age and sex Emily Atkins*1, Elizabeth Geelhoed1, Matthew Knuiman1, Tom Briffa1 1 School of Population Health, University of Western Australia, Perth, Australia Introduction: Hospitalisation for atherothrombotic disease (ATD) is associated with very low in-hospital death but high risk of readmission. The cost to the health system both in profile of readmissions and proximity to the index admission is poorly characterised. Objectives: To investigate the cost to the health system for an index hospitalisation with ATD and related readmissions at 90 days, 12, and 24 months by age and sex. Methods: All men and women aged 35-84 years admitted to a Western Australian tertiary public hospital in 2007 with a primary discharge diagnosis of ATD according to the International Classification of Disease version-10 Australian Modification were identified. Person-level linked hospital morbidity and mortality data over 2 years was obtained for each ATD case. Costs for the index admission and re-admissions were taken from Diagnostic Related Group codes and converted to 2013 Australian dollars using national health index deflators. Results: The 2007 sample included 6172 ATD patients (65% male; 74% coronary disease, 20% stroke, 6% peripheral vascular disease). A total of 783 (13%) died within
Introduction: m-health, or mobile phone-based technology in healthcare, is touted as a cost-effective solution to expand access and improve outcomes in low-resource settings. Despite the proliferation of software applications (“apps”), best practices in app development, particularly in low- and middle-income countries, remain uncertain. Objectives: To define best practices in the design, development, and field-testing of healthcare apps in a resource-scarce setting, in order to optimize usability and uptake. Methods: We conducted a qualitative study involving detailed interviews with stakeholders in the healthcare ecosystem, including patients, nurses, physicians, administrators, information technology staff, engineers, and software developers in hospitaland community-based settings in Mysore and Bangalore, India (n ¼ 130). We used prototypes (mock-ups or partially functional software) to elicit user preferences and to define development priorities. Inputs obtained from stakeholders were quickly incorporated into the next iteration of prototypes, and the process was repeated (“rapid prototyping”). Results: Stakeholders had a favorable view of mobile technology-based solutions for healthcare, but less than half had used a healthcare app prior to the interview. Despite higher marginal costs, patients strongly preferred voice-based solutions to text-based solutions because of limited literacy and numeracy, and unavailability of Indian-language phones. Providers preferred versatile apps that were accessible from a variety of devices (e.g., desktops, tablets, and phones); responsive web-based solutions that were platform-agnostic therefore outperformed native mobile solutions (e.g., Android or iOS clients) except in settings with limited internet connectivity. Drop-down fields produced significantly fewer errors and were faster than free-text entry. In projects involving low-literacy users or international collaborators, clarification of the syntax for error-prone fields significantly reduced user error and improved efficiency, e.g., dates (MM/DD/YYYY vs. DD/MM/YYYY), phone numbers (e.g., with or without preceding area code), and numerical inputs involving decimals (e.g., lab results). Data encryption and role-based password authentication were acceptable solutions for data security. Conclusion: Agile development practices involving rapid, iterative prototyping, and early, frequent engagement of patients and providers can yield valuable insights in the design and uptake of scalable m-health solutions. Disclosure of Interest: None Declared PW267 Australian Secondary Prevention Alliance: Health advocacy through unity Julie Redfern*1, Katherine Gall1, Clara Chow1,2, Secondary Prevention Alliance (Australia) 1 Cardiovascular Division, The George Institute; University of Sydney, 2Cardiology Department, Westmead Hospital, Sydney, Australia Introduction: Heart disease accounts for greater morbidity in Australia than any other disease state and 20% of deaths. Without a paradigm shift in the delivery of preventive services the number of individuals dying of repeat heart attacks is expected to double. Objectives: To describe the process, formation and structure of an Australian Alliance aimed at achieving advocacy and better delivery of secondary prevention services across Australia. Ultimately, the purpose is to describe an Australian plan for improving achievement of cardiovascular risk targets. Methods: To determine goals and identify organisations, a National consensus meeting of 40 participants representing Australian government and non-government agencies, consumers, health professionals (cardiology, primary care, nursing, allied health) and other key opinion leaders was convened. Feedback from discussions and surveys highlighted the need for formation of a National Alliance. Through a process of further surveys and stakeholder analysis an alliance was formed. An iterative and collaborative
e312
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
PW269 Modifying the Morisky Medication Adherence Scale by Adapting Two Items from the Brief Medication Questionnaire to Fit Assessing the Overall Adherence to Polypharmacy Regimen of Cardiac Patients
million women have GDM. However there is a huge shortage of trained physicians in India. Objectives: To address this need, a comprehensive high end training initiative in the form of Certificate Course in Gestational Diabetes Mellitus (CCGDM) is required for Physicians. Methods: An innovative and strategic partnership was established between Public Health Foundation of India (PHFI) and Dr. Mohan’s Diabetes Educational Academy (DMDEA), to train primary care physician, Obstetricians and Gynecologist on GDM by updated contents covering majority of salient aspects of GDM prevention, screening and management. Results: This uniquely designed program is aimed to train 1460 Primary Care Physicians, Obstetricians and Gynecologists of India in 55 Regional Centers, across India covering 16 states, 1 Union Territory and 39 cities with the backbone of 15 National Experts, 110 Regional Faculty and 25 Observers. The regional training centers serve as practice oriented skill enhancement centers and professional networking hubs. Sessions on GDM is conducted only on Sunday once a month for 4 consecutive months by regional faculty through use of standardized teaching material following standard operating procedures PAN India. Each center consist of dual expert i.e. Diabetologist/Endocrinologist and Gyn/Obst, each who act as Regional Faculty. National faculty empanelled across the country appraised the regional faculty on course curriculum and other modalities of the course. Educational material developed for program is latest, context specific, content and resource sensitive. Quality assurance of the educational program is ensured by necessary documentation, peer-reviews and by establishing alignment between module objectives, lectures material, case discussions, assignments & assessments. The educational grant for the program has been provided by Johnson & Johnson Medical India.
Ali Y. Nori*1, Muhamad S. A. K. Ali2, Baharudin Ibrahim1, Rahmat Awang3, M. Azmi Hassali1 School of Pharmaceutical Sciences, Universiti Sains Malaysia, 2Department of Cardiology, Hospital Pulau Penang, 3WHO Collaborative Center of Tobacco Control, Universiti Sains Malaysia, Penang Island, Malaysia
1
Introduction: Heart disease maintains being the leading cause of premature death in Malaysia. Careful follow up for cardiac patients is crucial to consistently optimize treatment and monitor the therapeutic plan. Although the term adherence is found in the Malaysian medical records, there is no standard method used in measuring compliance with the prescribed medications. However the Morisky Medication Adherence Scale (MMAS) is widely used in governmental hospitals, it is not accurately implemented when dealing with polypharmacy regimens. Objectives: This study aimed to evaluate the applicability and reliability of a modified version of MMAS after replacing two items of “medication discontinuation” and “medication missing” with a similar items adapted from the Brief Medication Questionnaire to establish a general measure of adherence to the multiple medications of cardiovascular disease (CVD). Methods: A pilot phase included 22 cardiac patients was run to demonstrate face validity for the modified MMAS as well as to improve the translation to the Malaysian language. Thereafter, 174 patients were surveyed where the original MMAS was administered before the modified extra two items along with other questions about demographics and barriers to adherence. The patients were categorized according to their diagnosis into: coronary heart disease, arrhythmias, heart failure, congenital heart disease, and valvular heart disease groups. Results: The mean age of the sample was 55 years (10.25), 80.6% were males, 46.9% were ethnically Chinese, monthly median income was z 330$ (1050 RM) and 81.1% were not current smokers. The mean number of daily CVD medications per patient was 5. Only 65.7% of the respondents had correctly taken the medications according to the prescribed instructions, whereas 73.7% had failed to name all their medications. 25.1% had a history of medication discontinue without doctor’s order. The internal consistency (Cronbach’s alpha reliability) of the original and modified MMAS were 0.583 and 0.588 a respectively. Significant Item-total correlation (P <0.01) and between both versions (0.898; P <0.01) manifests concurrent validity for the newly modified MMAS in addition to the retaining of the dimensional structure of a single-factor scale confirmed by factor analysis. Conclusion: Although the psychometric properties of both scales are similar, it is advised to use the modified MMAS to assess adherence to multiple drug therapy (polypharmacy) and get a clear picture about medication discontinuation behaviour. Disclosure of Interest: None Declared PW271 Implementation of educational training program in Gestational Diabetes Mellitus Management for obstetricians / gynecologist and primary care physicians in India Sourabh K. Sinha*1, Sandeep Bhalla1, V. Mohan2, Ranjit Unnikrishnan3, Pratibha Karnad4, K. S. Reddy5, D. Prabhakaran6 1 Training, Public Health Foundation of India, New Delhi, 2Chairman, 3Vice Chairman, Dr Mohans Diabetes Education Academy, Chennai, 4Education, Johnson & Johnson Medical India, Mumbai, 5Administration, Public health foundation of India, 6Executive Director, Centre for Chronic Disease Control, New Delhi, India Introduction: Given the global scenario around 366 million people suffering from diabetes in 2011, which is expected to rise to a total of 552 million by 2030. India alone has 62.4 million people with diabetes and 77.2 million people with pre-diabetes as of year 2011. GDM affects up to 15% of pregnant women worldwide and in India estimated 4
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
Conclusion: GDM program is an effort to build capacity among primary care physicians, gynecologist & obstetricians in Gestational Diabetes Mellitus Management. This unique and sustainable initiative hopefully serve as a trend setter in the field of diabetes education and help improve maternal and child health indices in India. Disclosure of Interest: None Declared
PW272 Role of nursing staffs as primary care givers in Management of Non Communicable Diseases with focus in Diabetes Mellitus in Rural India Utplakshi Kaushik*1, Sourabh K. Sinha2 1 Sneh, Family Health International, 2Training, Public Health Foundation of India, New Delhi, India
e313
POSTER ABSTRACTS
process of literature review and consensus (May-Aug 2013) led to establishment of agreed goals and key messages. An Advisory Council for individual input was also formed and the Australian Federal Government and policy-makers were successfully engaged. Communication is via teleconference, face-to-face workshops and electronic means. Results: The Secondary Prevention Alliance (Australia) was established (May 2013) with representatives from 19 national organisations. These include government and non-government stakeholders, professional organisations, consumers and the Heart Foundation. The Advisory Council consists of 149 individuals and experts from Australia, New Zealand, Europe and Canada with a variety of expertise in clinical roles (43%), education/ research (31%), health management (19%) and government (7%). The Alliance has already facilitated increased awareness of secondary prevention and has engaged media and government relations. The alliance also allows consensus on national models of care and indicators. Conclusion: The National Secondary Prevention Alliance has united stakeholders with the common goal of raising the profile of the need for improved health care services in Australia. The process provides an example of how national unity and common messages facilitates advocacy. Disclosure of Interest: J. Redfern Grant/research support from: AZ Educational Grant, K. Gall Grant/research support from: AZ Educational Grant, C. Chow Grant/research support from: AZ Educational Grant