PowerPoint Presentation · Title: PowerPoint Presentation Author: Jennifer Dickie Created Date:...
Transcript of PowerPoint Presentation · Title: PowerPoint Presentation Author: Jennifer Dickie Created Date:...
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Preventive Cardiology Clinic: An integrated approach to lifestyle medicine
Presented by: Shawn Hondorp, PhD, ABPPa,b
Co-authors: Emilee Ertle, B.A.a, Holly Dykstra, M.A.a, Lenora Eberhart, B.AS.a,b, Autumn Baldwin, B.S.N.a & Thomas Boyden, M.D.a,b
aPreventive Cardiology, Spectrum Health System, Grand Rapids, MIbCollege of Human Medicine, Michigan State University, Grand Rapids, MI
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Course Speaker Disclosure Information
Shawn Hondorp, PhD, ABPP
Disclosures
None
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Objectives
•Composition and flow of Preventive Cardiology clinic
•Case example
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Clinic Overview
• Open for 3.5 years
• Board certified cardiologist: Thomas Boyden, MD (0.4 FTE)
• Registered dietitian: Holly Dykstra, MA (0.2 FTE)
• Clinical health psychologist: Shawn Hondorp, PhD (0.4 FTE)
• Registered nurse
• Medical assistant
• Program specialist
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Referrals
• Cardiovascular risk assessment
• Family history of coronary heart disease
• Hyperlipidemia with statin intolerance
• Familial hypercholesterolemia
• Uncontrolled hypertension
• Obesity
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Do you have access to a clinic like this?
• Yes, we have a similar clinic at my institution or nearby where I can refer for preventive services
• Not exactly, but we do have a weight management clinic
• No, we don’t have anything like this
• I am not sure
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Screening Process
•Patient Health Questionnaire (PHQ-2)• Depressed mood, anhedonia
•Generalized Anxiety Disorder screener (GAD-2)• Anxiety, difficulty controlling worry
•Disordered eating:• Binge eating• Emotional eating• Food addiction
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Mediterranean Diet Scale (MDS)Please answer each question below by circling the number in the box for yes or no. No Yes
1. I eat at least 2 cups of vegetables every day. 0 1
2. I eat 2 or more pieces of fruit a day. 0 1
3. I eat 2 or more servings of whole grains a day. 0 1
4. I eat a handful nuts or seeds almost every day. 0 1
5. I use olive oil as my main source of fat. 0 1
6. I drink a glass of red wine (but no more than 2) most days. 0 1
7. I eat fish 2 or more times a week. 0 1
8. I eat beans or legumes 2 or more times a week. 0 1
9. I eat red meat no more than 2 times a week. 0 1
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Screening Data (chart review of 55 patients)
Measure Score
Binge eating 16%
Emotional eating 22%
Food addiction 18%
MDS 3.4 (SD = 2.3), minimally consistent with Mediterranean eating pattern
PHQ-2 > 0 33%
GAD-2 > 0 47%
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Case example
• 67 y/o female
• PMH: a-fib, hyperlipidemia, hypertension, OSA, obesity (BMI = 37 kg/m2)
• MDS = 0
• PHQ-9 = 23 (severe depression)
• GAD-7 = 19 (severe anxiety)
• Longstanding emotional eating pattern
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Case example (cont.)
• Saw dietitian 6 times and psychologist 12 times over ~12 months
• 27 lbs lost (11% weight loss, ended with BMI of 34 kg/m2)
• PHQ-9 = 6 (mild depression)
• GAD-7 = 3 (minimal anxiety)
• Minimal to no emotional eating
• Diet much more consistent with Mediterranean eating pattern
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If you did have access to a clinic like this, how often would you utilize it?• Often
• Occasionally
• Rarely
• I am not sure
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Discussion
• Consistent with 2019 ACC/AHA guidelines• Emphasis on patient-physician shared decisions
• Team-based approach
• Inter-clinic referrals reduce barriers and increase integrated care
• Lifestyle changes made by this patient and others would be expected to greatly reduce cardiovascular risk long-term