A pilot project at Beaumont Hospital in north Dublin is expected to ensure better care for many patients currently at risk of heart disease and stroke, as well as reducing hospital waiting lists.
The RHASP (Reduction of Heart Attack and Stroke) pilot project is part of the Government's cardiovascular strategy and will involve the use of a new management system for cardiovascular disease which has been developed by Prof Eoin O'Brien, consultant cardiologist at Beaumont Hospital.
The DABL/Cardiovascular system will initially be extended to six general practices in the hospital catchment area.
Funded by the Department of Health, the project will ensure each general practice is provided with the computer and communication facilities to allow full access to the Beaumont database, which contains detailed information on more than 25,000 patients with cardiovascular disease.
"All of these patients are stratified for cardiovascular risk and prognosis into high, medium and low risk categories. The information gathered on this large population of cardiovascular patients would be of much greater value if it were shared with the general practitioners from whom the patients had been referred," Prof O'Brien told The Irish Times.
High-risk cardiac patients benefit from intensive investigation and treatment to avert impending heart attack and stroke; those at low risk are best managed in family practice, he added.
The pilot initiative will be evaluated by independent assessors, who will look at the feasibility of establishing a common database between hospital and general practice and the benefits of a collaborative approach to the management of patients at risk of heart attack and stroke.
One of the key markers of the success of RHASP will be the reduction in the referral rate of low-risk cardiac patients by GPs to the hospital. If successful, the initiative will be extended nation-wide.
The use of the system within the hospital has already resulted in a 50 per cent reduction in waiting lists for the cardiovascular clinics at Beaumont. As a result, patients now wait less than 30 minutes before being seen. By extending the system to primary care, it is expected that up to 50 per cent of cardiac patients will avoid having to attend the hospital and will be managed exclusively in primary care.
Prof O'Brien said the greatest benefit in extending the database system to general practice would be the ability to establish a joint approach to vigorous risk factor management and appropriate treatment. He predicted a reduction in cardiovascular deaths "of the order of 50-60 per cent" if recent treatment benefits were implemented along with a joint approach such as RHASP. In 2001, 11,914 people in the Republic died from diseases of the circulatory system.
"Until we bring primary and hospital care together to manage heart disease we cannot hope to cope with the epidemic that has placed the Republic at the top of the table for death from heart attack in Europe. This project, which unites primary and secondary care, is a step in the right direction," Prof O'Brien added.