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According to the Dallas-based American Heart Association, failure to follow a physician’s advice can delay recovery from illness, increase medical costs, and heighten risk for certain conditions such as cardiovascular disease. That’s why the AHA has added a new section to its Web site that provides tools for health care professionals and consumers to aid compliance.
"One of the main things professionals have been asking for are tools they can use in clinical practice to help patients self-monitor their compliance and their behaviors. That is why the American Heart Association decided to take on this particular site," says Nancy Houston-Miller, BSN, RN, director of the Stanford Cardiac Rehabilitation Program at Stanford Medical Center in Palo Alto, CA, and head of a task force on patient education for the association.
The site is divided into two areas. The consumer area has information, tools, and tips on following appropriate professional advice about medications, diet, and exercise. The professional area provides tools to help patients comply with a physician’s treatment recommendations. The consumer and professional sites include the following information:
— Physician’s Tool Kit. Includes AHA Cardiovascular Disease Guidelines, a patient tracking form for the chart, a compliance brochure, tip sheet on how to increase patient compliance, and heart healthy diet references. The 91/2" X 12" folder of materials can be ordered online.
— Patient information sheets. These sheets, which are available on the Web site, provide information on a variety of risk factors, including smoking, blood pressure, cholesterol, physical activity, nutrition and weight management, medicines, and diabetes. They include space for individualized patient recommendations and some have charts so patients can track their progress. For example, the physical activity sheet offers suggestions for developing a plan for exercise and tips on how to make the necessary lifestyle changes such as setting specific and realistic goals. It also has a chart to track exercise so patients can determine if they are meeting their goals and information on how to determine a target heart rate to get the most from the exercise program.
— Compliance Challenge. To help develop a team effort, both patients and physicians can take a compliance quiz during an office visit and then sign a compliance pledge. The physicians’ quiz includes such yes/no questions as: "When it comes to developing a health regimen, I involve my patients in the decision, getting their input on prescriptions, diet, and exercise changes," and "Whenever I make diet recommendations I carefully explain why the changes are important. I also suggest what foods and cooking methods to avoid and new things to try." The patients' compliance quiz includes such questions as: "Have you ever been confused about what [medication] side effects to expect and what to do?" and "Are you confused about what type of exercise you should be doing?"
— Consumer area of site. Practitioners can refer patients to the consumer site, which helps teach patients how to be more compliant with medications and lifestyle changes.
— Records to increase compliance. Patients can print charts to help track medications, blood pressure, cholesterol, physical activity, food intake, and weight management. The charts are designed to help patients develop better daily habits. For example, the cholesterol compliance chart explains what cholesterol levels mean and provides a section for tracking blood cholesterol level, HDL cholesterol level, LDL cholesterol level, and triglyceride level.
— Health risk awareness quiz. This quiz is designed to help people understand their personal heart health challenges and identify risk factors. Risk factors include less than 30 minutes of physical activity on most days and being 20 pounds or more overweight for a person’s height and build.
— Lifestyle information. These educational sheets provide tips on such lifestyle issues as nutrition, physical activity, and smoking. For example, tips for handling the urge to smoke include: "Change your habits. Instead of having a cigarette after dinner, brush your teeth or walk the dog," and "Write down the reasons why you quit and look at the list often."
— Medication Checkup. This section gives patients advice on what to do when they are confused about how to take their medications and what they are for.
The Web site benefits the health care professional by providing developed tools that have been tested. Doctors need only tailor them to their needs. It helps patients by providing them the skills and tools to monitor their compliance every day. "We know compliance is not just the patient’s problem. It is the problem of the patients, the provider, and the health care system. It is all three having to work together," explains Houston-Miller.
• American Heart Association, 7272 Greenville Ave., Dallas, TX 75231-4596. Telephone: (800) 242-8721. Web site: www.americanheart.org/CAP.