Berwick Medical Centre

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Australian Primary Care Collaboratives

Berwick Medical Centre is one of 600 general practices across Australia to have joined the Australian Primary Care Collaboratives which commenced in 2003. The Collaboratives aim to improve clinical outcomes, reduce lifestyle risk and maintain good health for patients with a range of chronic conditions as well as promoting a culture of quality improvement within the practices.

Practices initially focus on chronic heart disease and diabetes. Some of the improvements that have occurred within participating group over the past 3 years are :

For Coronary Heart Disease   ( CHD )

  1. 28% improvement in patients with CHD taking aspirin
  2. 26% improvement in patients with CHD taking statins
  3. 50 % improvement in patients with CHD whose last recorded BP is <= 130/80

For Diabetes

  1. 97% improvement in diabetic patients having HbA1c < 7 %
  2. 132% improvement in diabetic patients with total cholesterol  < 4 mmol/l
  3. 101% improvement in diabetic patients whose last BP was <=130/80

These results are  significant when it is know that aspirin reduces the risk of a major cardiovascular episode like heart attack by 22% within  2 years for a patient with demonstrated vascular risk like a previous heart attack, lowering cholesterol has a 22% reduction for relative risk of a major cardiovascular event and lowering BP to target sees a 21% reduction in mortality within a 3 year period.

For diabetics there is a 21%  reduction in diabetes related causes of death for every 1% reduction in HbA1c and a 14 % reduction in death from any cause for each 1% reduction in HbA1C and only 9 % of diabetics had total cholesterol of  < 4 mmol/l  – if   abnormal cholesterol levels  are  reduced to < 4 mmol/l then  there is  a  25%  reduction in these diabetic patients presenting to hospital or the Emergency  department within 3 years.

Smoking > 1 cig /day results in a 10% risk of CHD death this risk drops to 6% within 3 months of cessation of smoking and recent research suggests this becomes 4% –  the same risk as a non smoker within 3 years of ceasing smoking.

It is know to us (as GP’s) that most patients following heart attack are recommended and prescribed ongoing medication including aspirin, statins, ACE inhibitors or beta blockers which should not be ceased except on medical advice as they are known to reduce the risk of further major cardiovascular events and patients are referred for GP followup for these treatments. However 1/3 of patients following their heart attack will cease some of their medication without seeking medical advice within 12 months of their heart attack and 1/8 will cease all their medication within 12 months even though ample research exists to demonstrate they place themselves in jeopardy by doing so.

It is for these reasons that Berwick Medical Centre has engaged in the APCC collaborative and why we ask you to cooperate with the changes this will introduce as it will result in proven health benefits to you the patient.