Heartwatch project: There is an urgent need to clarify the future of a national primary care programme for the prevention of heart disease, an expert has said.
Prof Andrew Murphy of the Department of General Practice at the National University of Ireland, Galway, said the failure of the Department of Health and the Health Service Executive (HSE) to decide whether to continue with the Heartwatch programme was "regrettable".
Speaking to The Irish Times following the publication of a new study highlighting the importance of preventive treatment for patients with existing heart disease, Prof Murphy said: "Heartwatch is the Irish national pilot programme, based on about 20 per cent of general practices, for the organised provision of preventive care to patients with established heart disease.
"It is regrettable that, despite being in existence for over three years and after two completed evaluations, no decision has been made regarding its continuation.
"Indeed, neither report has been made available for general comment which seems to defeat the whole purpose of having a pilot evaluation. Our recent research results highlight the urgency of a decision being made regarding the future of Heartwatch."
The Heartwatch programme is run by the Irish College of General Practitioners and funded by the Department of Health. Patients with a history of heart attack and those who have had cardiac bypass surgery or angioplasty (the insertion of a stent in a blocked coronary artery) are checked at quarterly intervals by family doctors to ensure that coronary risks are controlled.
Some 460 GPs have carried out almost 82,000 consultations on more than 13,000 patients since the programme began in 2003.
A Department of Health spokeswoman said it had been agreed that a further analysis, covering the first 24 months of Heartwatch, would be made available. "These analyses are being finalised at the moment and both reports will be presented to the Minister in the near future."
The latest research on secondary cardiac prevention in the Republic, published in the international journal, Family Practice, found that patients with a diagnosis of angina were less likely to receive appropriate preventive treatment than people who had a heart attack.
The study of 1,611 patients living in the west and northwest was carried out by Prof Murphy, Dr Molly Byrne and their colleagues from the departments of general practice and psychology at the National University of Ireland and the department of public health and epidemiology, University College Dublin.
However, the study found that, overall, patients here receive as much preventive treatment as people with cardiac disease living in the UK and Australia.
Welcoming the recent news that deaths from heart disease in the Republic have fallen by 50 per cent in the past 10 years, Prof Murphy said: "Our results suggest that, in comparison to the UK and Australia, patients in Ireland are receiving just as much preventive treatments despite the lack of nationally organised, chronic disease management care in Ireland. So it is very much a case of the glass being half full in difficult circumstances."
But there were differences between patients in how well prevention guidelines were followed.
Men were more likely than women to have normal cholesterol levels and carry out exercise within recommended limits. Some 64 per cent of women adhered to a low-fat diet compared with 47 per cent of men.
Patients with angina only, compared with patients who had a heart attack or required cardiac surgery or a cardiac stent, were significantly less likely to have been prescribed aspirin, lipid- lowering drugs and other medications known to prevent further cardiac problems.