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Proactive case finding and retention and improving access to services in disadvantaged areas (Health Inequalities) Statins

Turley, Ruth Louise, Weightman, Alison Lesley, Morgan, Fiona, Sander, Lesley, Morgan, Helen Elizabeth, Kitcher, Hilary and Mann, Mala K. 2007. Proactive case finding and retention and improving access to services in disadvantaged areas (Health Inequalities) Statins. [Project Report]. London: NICE. Available at:

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Coronary heart disease (CHD) is the largest single cause of death, claiming 37% of the UK total. The burden of CHD is directly linked to the increasing inequalities health in the UK. The death rate due to CHD among men from manual classes is 40% higher than for non-manual workers. Men of working age in social class V are 50% more likely to die from CHD than men in the population as a whole. The wives of manual workers have nearly twice the risk compared to wives of non-manual workers. There are also ethnic variations. For people born in the Indian sub-continent, the death rate from heart disease is 38% higher for men and 43% higher for women than rates for the country as a whole. Therefore improving the primary and secondary prevention of cardiovascular diseases in disadvantaged groups will be a significant driver in tackling health inequalities. Primary prevention of cardiovascular diseases requires identification of patients at high risk and treatment of eligible patients. Secondary prevention also requires identification and treatment of those with established CHD. The National Service Framework for Coronary Heart Disease set standards for general practitioners and primary cares to identify all people with established cardiovascular disease and people at significant risk and offer comprehensive advice and appropriate treatment. The use of statin therapy is recommended for adults with clinical evidence of cardiovascular disease and as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD2. For effective prevention it is important that once identified, patients access services and comply with their treatment. These are key factors to consider for disadvantaged groups who may face additional barriers such as transport, inconvenient appointment times and language / communication. This review therefore seeks to address the interventions for finding and supporting adults from disadvantaged populations who are at increased risk of developing CVD or who have CVD. The research questions are as follows: 1. What interventions could PCTs introduce to identify and reach people at increased risk of developing or with established CHD 2. Once identified and reached, how do PCTs support people at increased risk of developing or with established CHD? 3. How can PCTs provide or improve access to services aimed at people at increased risk or with established CHD? This review has been developed in line with the parameters agreed with the CPHE team at NICE.

Item Type: Monograph (Project Report)
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Social Sciences (Includes Criminology and Education)
Academic & Student Support Service
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Publisher: NICE
Funders: NICE
Date of First Compliant Deposit: 30 March 2016
Last Modified: 14 Feb 2022 08:15

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