A Heart Foundation pilot program that recalls at-risk Australians via a text message from their GP clinic, is being seen as a potential lifesaver.
The Heart Health Check (HHC) Recall pilot study was rolled out in more than 200 GP clinics across the country, where about 42,000 at-risk Australian patients received an invitation from their GP to come in for a HHC via SMS, which led to a 14-fold increase in HHCs compared to control practices.
Results were recently published in the Australian Journal of General Practice.
The pilot is the largest targeted cardiovascular disease (CVD) screening trial of its kind in Australian general practice, potentially paving the way for a structured Australian CVD screening program in the future.
This is the most robust Australian evidence we have that shows a targeted CVD screening program could be both effective and feasible in general practice. Just like Australia has dedicated screening programs for many cancers, we need to consider one for Australia’s leading cause of death, heart disease.”
Natalie Raffoul, Healthcare Programs Manager, Heart Foundation
Heart Health Check (HHC) Recall pilot
The pilot program sent direct SMS messages from GP clinics to existing patients, via the GoShare Plus software, embedded into established clinical practice software via a randomized control trial design.
Patients who were invited to come in for a HHC via a personalized SMS met the following criteria;
- Aged 45 to 74 years of age
- Not already living with CVD
- Had not had a health assessment or HHC in the previous 12 months
- Total cholesterol and high-density lipoprotein cholesterol recorded in the previous 12 months
- An active patient (at least three visits to the GP in the previous two years)
Patients have avoided life-threatening events
New South Wales GP, Dr Raya Grishina-Gunn said the pilot program allowed her to treat patients at high risk of having a heart attack or CVD event, unbeknown to them.
“Thanks to the HHC Recall pilot program, I identified several high-risk patients after conducting their Heart Health Checks,” Dr Raya said.
“Based on their results, some patients were then referred onto cardiologists for further investigation and procedures.”
While patients avoided potentially life-threatening events, the pilot program also afforded the clinic the opportunity to discuss and highlight the importance of a healthy heart.
“Thanks to the pilot program, it was found that some patients needed stents to rectify blocked arteries, some patients who were found to be at high risk of having a heart attack or stroke in the next five years were prescribed medication, while I worked with others to help them make lifestyle changes to lower their risk and keep on top of their heart health,” Dr Raya said.
After the personalized messages were sent to those patients who met the program’s criteria, Dr Raya’s clinic was surprised by the number of booking requests that came through.
“Our patients were really excited to be recalled in for a HHC and our phone lines were very busy with people wanting to book a check after the messages went out,” she said.
I’m physically active, followed the best diet, but I was a ticking time bomb
One of those patients was grandmother of two, Katrina Wilkes who responded to an SMS inviting her to Dr Raya’s clinic for a HHC, as part of the HHC Recall pilot program.
The proactive 59-year-old has spent her adult life committed to keeping her heart healthy, after she lost her dad to a massive heart attack when he was 47.
“I have always been physically active, followed a healthy diet, looked after myself and felt well,” Katrina said.
“If I had not received that SMS inviting me in for a Heart Health Check, the situation could be very different today.”
After completing the 20-minute Medicare-subsidized HHC as part of the pilot program, Katrina was shocked when she was told she had high cholesterol and high blood pressure; and both needed to be treated with medication.
“Dr Raya also referred me to a cardiologist, where I underwent an angiogram and coronary artery calcium scoring, and it was revealed I had calcification of the arteries,” she said.
“I couldn’t believe it. I had done sport all my life, I follow an excellent diet but I had serious and deadly heart issues, which could have led me to suffering a heart attack.”
Katrina believes programs like the HHC Recall pilot can change lives.
“My husband and I want to enjoy life, we adore and cherish the moments we are with our children and grandchildren, and I want to be around for them and with them; I want to be around for a long time; and now thanks to the right intervention; my medication, I can,” she said.
Being at high risk of heart disease can be almost completely symptomless until it’s too late.
Quite often, the first sign of heart disease is a heart attack.
“International CVD and chronic disease screening programs have been rolled out in the UK and New Zealand, helping to boost early detection of CVD and help people better manage their risk factors,” Ms Raffoul said.
“The time has come for Australia to reap the health and economic benefits of developing its own CVD screening program.”
Heart Foundation
Raffoul, N., et al. (2023) Feasibility of a text-mediated recall system to increase cardiovascular disease risk assessment in general practice: Mixed-methods pilot evaluation. Australian Journal of General Practice. doi.org/10.31128/AJGP-08-22-6541.