Will a web-based cardiovascular disease (CVD) risk assessment programme increase the assessment of CVD risk factors for Maori?

Abstract

Abstract Background Mäori suffer disproportionately from cardiovascular disease despite the national priority of reducing inequalities. National guidelines on the clinical management of CVD risk recommend a comprehensive risk assessment be completed as a prerequisite for identifying patients most likely to benefit from treatment. Methods A retrospective audit of GPs using PREDICT-CVD (an electronic risk assessment and management tool) was designed with adequate explanatory power for Mäori to determine if it could increase CVD risk assessment without increasing inequalities. 1680 electronic medical records (EMRs) prior to implementation and 1884 after implementation of PREDICT were audited. Results Documentation of CVD risk increased from 3.2% of EMRs to 14.7% of EMRs in Mäori, and from 2.8% to 10.5% in non-Mäori. The documentation of individual CVD risk factors also increased post-implementation of the tool. Conclusions The implementation of PREDICT-CVD was as likely to increase documentation of CVD risk assessment and risk factors in Mäori as in non-Mäori. However documentation was still low in Mäori despite known high prevalence of CVD risk factors. A comprehensive quality-driven implementation programme is recommended, including targeting risk assessment for those most in need.