Around two-thirds of Australians eligible for cardiovascular risk screening have not visited their GP for a heart health check during the past two years, despite some carrying high risk factors for heart attack or stroke, according to a new survey by the Heart Foundation.
The survey of 1,000 Australians, released during this year’s Heart Week (2-8 May), found 64% of people aged between 45 and 74, representing 5.5 million people, hadn’t had a heart health check with their GP in the past two years. This was despite more than half having either high blood pressure, high cholesterol, diabetes, or being told they are at high risk of heart disease by a doctor.
On the back of the results, the Heart Foundation is urging Australian clinicians to boost promotion of preventative cardiovascular screening activities in the wake of the disruption caused by the pandemic, combined with healthcare provider burnout and emerging data on the impact of COVID-19 infection on adverse cardiovascular outcomes.
When asked what would motivate them to see their GP for a heart health check, more than half of survey respondents said a recommendation by their GP would motivate them the most to book a test.
“Cardiovascular disease prevention has never been so critical,” Heart Foundation interim CEO Professor Gary Jennings says.
“It is clear through these findings that GPs and nurses have the power to make a difference – your recommendation or invitation for a preventative checkup is the most powerful tool we have to encourage this essential screening activity.”
While the Australian Primary Health Care Nurses Association (APNA) acknowledges the issue, it says PHC nurses are in desperate need of extra help and do not have the time to conduct heart health education.
A survey of 1,061 PHC nurses by APNA found almost one in three PHC nurses do not perform cardiovascular education and management with patients due to mounting work and resource pressures.
The survey revealed less than a quarter (24%) of PHC nurses conduct cardiovascular education and management on a weekly basis; only (20%) of PHC nurses conduct cardiovascular education and management monthly; and almost one in three (30%) PHC nurses never conduct cardiovascular education and management at all.
Tellingly, more than four in five (80.4%) primary healthcare nurses surveyed said they felt exhausted at work.
APNA believes the gap in PHC nurse heart health education could be filled by bringing in student nurses into primary healthcare settings, such as general practices or community health, to perform supervised activities.
The move would simultaneously relieve pressure on overworked PHC nurses whilst boosting students’ skillset, and establish a pipeline of new, skilled, and experienced PHC nurses for the future, the organisation argues.
An existing APNA-run nursing student placement program already allows nursing students to play a role in primary healthcare settings while accruing their required clinical placement time under the supervision of experienced primary healthcare nurses.
Building the program so that it can be coordinated nationally would provide “a workforce pipeline of motivated and skilled nurses” who could help ease the staffing crisis in aged care homes, general practice, and other primary health care settings across the country, APNA says.
Placing more student nurses in primary healthcare settings to carry out supervised learning and skills training would also support higher rates of screening for chronic disease, which is forecast to increase due to COVID-19.
“Australia cannot afford for primary healthcare nurses to be too busy to provide heart health education to patients,” APNA President Karen Booth said.
“Along with cardiovascular screening, it is one of the most affordable and efficient ways of keeping Australia healthy and promoting better patient outcomes.
“If this situation continues, we will undoubtedly see a much greater number of critically ill cardiovascular patients needing emergency hospital treatment and putting more strain on the health budget.”
Ms Booth said primary health nurses offer the most affordable and effective way of keeping cardiovascular patients healthy and out of hospital.
“Patients deserve to receive treatment and education from nurses who aren’t run off their feet with too much else to do. Using supervised nursing students as an added resource for nurses will give them extra time and resources to devote to patient care.”
During Heart Week 2022, the Heart Foundation is encouraging health professionals to make good use of the Heart Health Check Toolkit to easily assess and manage CVD risk in their eligible patients.
Over 53,000 people have accessed the health professional Toolkit since it was introduced last year, including Heart Health Check assessment and management templates, quality improvement tools and patient engagement resources. New resources have also been introduced during Heart Week to support the clinical management of high cholesterol and encourage a healthy lifestyle.