PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

The NT Government has partly funded the Preventable Chronic Disease Strategy,which is an overarching framework for the development and delivery ofpreventative services to the chronically ill. Implementation of this strategyrequired further examination of the interventions or „disease management‟strategies that have been proved to be effective or efficacious for chronic diseasemanagement. The findings from this study suggest that adherence to GSATguidelines needs to be better in order to achieve desirable changes in patientoutcomes (104) .There has been considerable public debate regarding the decline in blood pressure control andthe resulting renal death rates reported from the Menzies program at the time of handover toTerritory Health Services in 2002, which were reported in 2005 by Hoy and Kondalsamy-Chennakesavan (100) . In 2006 Bailie reanalysed these data (106) . He found that the trend overtime in the key intermediate outcome indicator of blood pressure control does not support theconclusion they had reached regarding the impact of the handover of the program, and thatthere had been a decline in blood pressure control as early as the 2 nd year after entry into theprogram (106) . That year Hoy stated that a number of „non-renal‟ deaths had been reported inthese data and an intensity of management had been relaxed (107) .Figure 5.8 below demonstrates the trends in monitoring and control of blood pressure of asample of 98 patients with greater than 78 months of follow-up. They were found not to bestatistically different from the rest of the participants on a range of parameters – age, gender,GFR, creatinine, SBP, DBP – except for having a higher proportion with diagnosed hypertension(106) . There was a significantly declining trend from 12 months to the end of follow-up and therewas no significant change in trend at time of handover.Figure 5.8Trends in monitoring and control of blood pressure.Chapter 5: Key Result Areas – Evaluation of the NT Preventable Chronic Disease Strategy 2007 92