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Research

Evaluating a cardiovascular disease risk management care continuum within a learning healthcare system: a prospective cohort study

T Katrien J Groenhof, A Titia Lely, Saskia Haitjema, Hendrik M Nathoe, Marlous F Kortekaas, Folkert W Asselbergs, Michiel L Bots and Monika Hollander UCC CVRM study group
BJGP Open 2020; 4 (5): bjgpopen20X101109. DOI: https://doi.org/10.3399/bjgpopen20X101109
T Katrien J Groenhof
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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  • ORCID record for T Katrien J Groenhof
  • For correspondence: t.k.j.groenhof{at}umcutrecht.nl
A Titia Lely
2Wilhelmina Children’s Hospital Birth Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Saskia Haitjema
3Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
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Hendrik M Nathoe
4Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
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Marlous F Kortekaas
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Folkert W Asselbergs
4Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
5Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
6Health Data Research UK, Institute of Health Informatics, University College London, London, UK
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Michiel L Bots
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Monika Hollander
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Article Figures & Data

Figures

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  • Figure 1.
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    Figure 1. Flowchart of patient selection and risk factor assessment overview
  • Figure 2.
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    Figure 2. The multidisciplinary care continuum for blood pressure, LDL-cholesterol, and glucose management

Tables

  • Figures
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    Table 1. Percentage of registration of factors in JGPN
    Risk factorsBefore UCC (%), total n =751After UCC (%), total n = 751
    Smoking2717
    Alcohol use2113
    Height64
    Weight2719
    BMI2517
    Family history of CVD <60 years106
    Physical activity2013
    Systolic blood pressure4329
    Diastolic blood pressure4329
    HDL-cholesterol3721
    LDL-cholesterol3621
    Triglycerides3721
    Total cholesterol3721
    Glucose (fasting or non-fasting)4327
    eGFR4627
    Number of risk factors availablea
     04871
     1–32822
     4–62415
    • aFrom: smoking, alcohol, BMI, systolic blood pressure, low-density lipoprotein, glucose, renal function, physical activity.

    • JGPN
      Julius General Practitioners' Network
      UCC
      Utrecht Cardiovascular Cohort
      BMI
      body mass index
      CVD
      cardiovascular disease
      HDL
      high-density lipoprotein
      LDL
      low-density lipoprotein
      eGFR
      estimated glomerular filtration rate
    • View popup
    Table 2. Risk factor profile measured at UCC inclusion
    None of RFX registered in JGPN before referraln = 359 (48%)At least one of RFX registered in JGPN before referraln = 392 (58%)
    Mean age, years(SD)52 (18)65 (16)
    Women, n(%)190 (53)189 (48)
    Anthropometry
    Mean BMI kg/m2 (SD)25 (5)28 (6)
    Mean height, cm (SD)174 (14)171 (11)
    Mean weight, kg (SD)78 (18)80 (18)
    Lifestyle
    Currently smokes (missing 12%)43 (14)38 (11)
    Current alcohol use (missing 12%)192 (63)188 (53)
    Physical activity, minutes per week (missing 25%)1881 (1285)1666 (1233)
    Laboratory measurements
    Mean systolic blood pressure, mmHg (SD)133 (20)146 (24)
    Mean diastolic blood pressure, mmHg (SD)79 (12)81 (13)
    HDL-cholesterol1.4 (0.4)1.4 (0.5)
    LDL-cholesterol3.2 (1.3)3.1 (1.3)
    Triglycerides1.6 (1.2)2.0 (2.4)
    Total cholesterol5.3 (1.5)5.3 (1.6)
    Mean eGFR (1.73/ml/min, [SD])91 (25)79 (21)
    Mean HbA1C, mmol/mol (SD)38 (10)53 (12)
    History of CVD
    Coronary heart disease28 (7.8)83 (21)
    Chronic heart failure28 (7.8)30 (7.7)
    Stroke34 (9.5)65 (16.6)
    Peripheral artery disease19 (5.3)46 (12)
    • RFX
      risk factor
      JGPN
      Julius General Practitioners' Network
      UCC
      Utrecht Cardiovascular Cohort
      BMI
      body mass index
      CVD
      cardiovascular disease
      HDL
      high-density lipoprotein
      LDL
      low-density lipoprotein
      eGFR
      estimated glomerular filtration rate
      HbA1c
      glycated haemoglobin

Supplementary Data

SUPPLEMENTARY MATERIALS

  • bjgpopen20X101109_Supp.pdf -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

SUPPLEMENTARY MATERIALS

  • bjgpopen20X101109_Supp.pdf -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

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Evaluating a cardiovascular disease risk management care continuum within a learning healthcare system: a prospective cohort study
T Katrien J Groenhof, A Titia Lely, Saskia Haitjema, Hendrik M Nathoe, Marlous F Kortekaas, Folkert W Asselbergs, Michiel L Bots, Monika Hollander
BJGP Open 2020; 4 (5): bjgpopen20X101109. DOI: 10.3399/bjgpopen20X101109

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Evaluating a cardiovascular disease risk management care continuum within a learning healthcare system: a prospective cohort study
T Katrien J Groenhof, A Titia Lely, Saskia Haitjema, Hendrik M Nathoe, Marlous F Kortekaas, Folkert W Asselbergs, Michiel L Bots, Monika Hollander
BJGP Open 2020; 4 (5): bjgpopen20X101109. DOI: 10.3399/bjgpopen20X101109
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Keywords

  • learning healthcare system
  • continuity of patient care
  • cardiovascular risk management
  • cardiovascular diseases

More in this TOC Section

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  • “I was lucky!” A mixed methods study exploring how practice placements affect F2 doctors’ attitudes to a GP career
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