Kanyini Vascular Collaboration Update

The Kanyini Vascular Collaboration is a research project to try and identify barriers to best practice chronic disease management in Aboriginal and Torres Strait Islander people to improve their health.

The fifth Kanyini newsletter is now available.

The data collection for the Kanyini Qualitative Study is now complete. This was a huge task with 200 interviews conducted at all sites and an evaluation of the data has commenced. The planning for the Adherence Guidelines for the Polypill study is under way and we expect to kick of this part of the study this year.

Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit was published in the Medical Journal of Australia in November last year. At first glance the figures appear damning for the work we do in Indigenous Health. From the article:

  • More than half the people in the sample (53%) were not adequately screened for CVD risk according to national recommendations.
  • 9% of the sample had established CVD, and 29% of those aged 30 years were classified as high risk.
  • 40% of those with CVD were not prescribed a combination of blood pressure (BP) medicines, statins and antiplatelet agents
  • 56% of high-risk individuals without CVD were not prescribed BP medicines and statins.
  • For high-risk individuals not prescribed BP medicines or statins, 74% and 30% respectively, did not meet 2004 NHFA criteria for prescribing of these medications
  • Of those already prescribed BP medicines or statins, 41% and 59% respectively did not meet respective guideline targets

There are many reasons for this. Scripts becoming out of date because either the doctor or patient hasn’t been at the clinic when the other has for a consultation and review prescription, patient refusing treatment or is very transient perhaps with a prescription at a neighbouring health service. But even so the figures sound pretty bad.

The conclusion of the article brings some relief.

These management gaps are similar to those found in non-Indigenous health care settings, suggesting deficiencies across the health system. Prescribing guidelines which exclude many high-risk individuals contribute to suboptimal management. Guideline reform and improved health service capacity could substantially improve Indigenous vascular health.

However with Indigenous Australians having a total disease burden 2.5 times more than the rest of us we do need to do better.

Reference: Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit.
David P Peiris, Anushka A Patel, Alan Cass, Michael P Howard, Maria L Tchan, John P Brady, Joanne De Vries, Bernadette A Rickards, Della J Yarnold, Noel E Hayman and Alex D Brown
MJA 2009; 191 (6): 304-309

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Robbo

Robbo is a pharmacist working with a very remote Aboriginal Health Service in the deserts of Western Australia. + Andrew Robbo Roberts

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