CORONARY HEART DISEASE MANAGED CLINICAL NETWORK
CARDIAC SYMPOSIUM FOR GPS & ALLIED STAFF
Wednesday 14 November 2007
Venue: Aberdeen Medio-Chirurgical Hall, University of Aberdeen,
Foresterhill Site
Programme– on CHD MCN webpage
Delegate Attendance List
Bansal Anjali (GP), Rubislaw Medical Group, 7 Rubislaw Place, Aberdeen
Bennett Anne, Cardiac Rehab Nurse, Westburn Centre
Bruce Gillian (GP) Great Western Road Practice pm session only
Bruce Jenny, Dietitian, ARI
Burnett Francis Cardiac Nurse, Mintlaw
Chong Yuen (GP) Stonehaven Practice
Close Carol (GP) Gilbert Road Medical Practice
Collins Tony Public Involvement Representative
Copland Shirley Dr Associate Specialist, Diabetic Clinic, Wards 27/28, ARI (pm session only)
Craik Mary (GP) Albyn
Crothers Claire (GP) Holburn Medical Group (pm from 1.30pm)
Cruickshank Pat Cardiac Nurse, Inverurie Health Centre, Constitution Street
Dick N , Radiographer
Dinesh Krish (GP Principal) Gilbert Road Med Group, Bucksburn
Duguid Mary Cardiac Rehabilitation Nurse, Banff
Duthie Katrina (GP) Turriff Medical Practice
Elfellah Mohamed – SpR, Cardiovascular Pharmacy
Farquhar Sheena Cardiac Nurse Inverurie Health Centre, Constitution Street
Finlayson Jenny (GP) Northfield Medical Practice (pm session only)
Forbes Lynne (GP) Rosemount Practice
Furste Wolfgang (GP) Camphill Medical Practice
Garrick Heather, Radiographer
Grant Wilma (GP) Locum, Old Aberdeen Medical Practice
Guthrie Tricia (GP) Turriff Medical Practice
Haut Antje (GP) Peterculter - (pm session only)
Henderson Andrew (GP), Kincorth Medical Centre, 26 Abbotswells Crescent, Kincorth
Henderson Isabel (GP) Scotstown Med Group (pm session only)
Hinkley Kevin (GP) ?Reg at WoodendHospital
Houliston Mark (GP)
Inkson Joanne (Salaried GP) Forres HC
Johnston Claire (GP) Career Start Stonehaven Practice (pm session only)
Knight Margaret (GP) Northfield Med Practice
Lamberton Robert (GP) Scotstown Med Practice (pm session only)
Lanyon Karen (GP) Insch Medical Practice
Lovegrove Joey, Practice Nurse, Banchory Practice
Lynch Dorothy (GP) Holburn Medical Group (pm session only)
Lyons K (GP) Aberchirder
Macfarlane Mhairi (GP) Holburn Medical Group (pm session only)
MacIver Diane, Practice Nurse, Elgin HC (Community)
MacKay Ian (GP) Ellon Health Centre
Maheshwari (GP) Locum GP Crimmond
Manson Amanda BHF Heart Failure Nurse, Orkney
Matheson Millie Staff Nurse, wards 19/20/9c ARI
Maybin Jenny (GP) GP Registrar, Forres
McAlpine Dr Kenneth, Consultant, WoodendHospital
Mcdonald Ruth, Cardiac Rehabilitation Physiotherapist, Banff
McGoldrick Lynn (GP), Stonehaven Practice – pm only
McKerchar Duncan (GP) Portsoy
McLeod Ewen, (GP) The Clinic 13 Provost Craig Road, Ballater
Millar Elizabeth Sen Staff Nurse wds 19/20/9c, ARI
Mirza Aaisha (GP) GP Speciality Training Registrar, Elmbank Practice
Montero Nicole (GP) pm only
Morley Maria (GP) GP Registrar Old Machar Practice
Morton Katrina (GP) Banchory Practice
Munro Cameron (GP) Holburn Medical Group (pm session only)
Murphy Pilar (GP), Ellon Health Centre
Patel Manju Planning Lead for Acute, Foresterhill House
Paton Robert Public Involvement
Pirie Keith (GP) Authenblae Surgery
Riddell Rebecca (GP) Danestone
Rutledge David (GP) Inverurie Medical Group
Scott Jane (GP (GP Assistant), Gilbert Road Medical Group
Shepherd Jenny (GP), Brimmond Medical Group
Sim Graeme (GP) Locum
Simpson Bill, Lipid Clinic (Secondary Care)
Smart Anna (GP) Carden Medical Centre
Smith Ann Practice Pharmacist, G-Med, DavidAndersonBuilding
StarK Gavin (GP) Victoria Street Med Group (pm session only)
Steven Valerie (GP) Carden Place Medical Centre
Stout John (GP), Peterhead Medical Practice
Strachan Bruce (GP) Peterhead Health Centre
Sutherland Fraser (GP) Victoria Street Med Group PM attendance only
Tait Helena Staff Nurse Peterhead
Taylor Anne, Lead Pharmacist, Aberdeen CHP
Taylor Jack (GP) Aboyne
Taylor Laura Sport & Recreation Services, University of Aberdeen
Taylor Tracy (GP) Rosemount Medical Group (pm session only)
Thain JoanCardiac Rehabilitation HV Holburn MG
West Catriona (GP) GP Reg Stonehaven (pm session only)
Wilkinson Alistair (GP) Great Western Road Practice (pm session only)
Presenters/Sponsors and organisers
Anderson Brenda, Cardiac Rehabilitation Project Manager
Black Jim, Lead GP, CHD Managed Clinical Network
Broadhurst Paul, Consultant
Broom Iain, Consultant
El-shafei Hussain, Consultant
Gray Christine, Secretary, CHD Managed Clinical Network
Hannah Andrew, Consultant
Hillis Graham, Consultant
Jennings Kevin, Consultant
Little Jonny, Astra Zeneca
Metcalfe Malcolm, Consultant
Oldroyd Keith, Consultant
Reid Sandy, Network Manager, CHD Managed Clinical Network
Speight Ginny, Servier
Presentations
Cardiac Rehabilitation and Beyond – the Grampian Experience – Brenda Anderson
New SIGN Guidelines – Malcolm Metcalfe
Treatment of Dyslipidaemias and the new Grampian guidelines – Iain Broom
Cardiac Intervention – is the surgeon obsolete? – Keith Oldroyd
Cardiac Intervention – Should the cardiologist stop playing? – Hussein El-Shafei
Palpitation – Paul Broadhurst
Chronc Heart Failure – Andrew Hannah
Chest Pain – Steve Walton
How to manage AF – Kevin Jennings
Presentations can be accessed via the Coronary Heart Disease website – link as follows:
A paper copy of the presentation handouts can be obtained on request from Christine Gray at the CHD Managed Clinical Network office – telephone (01224) 556713.
Feedback
Thirty-seven post course evaluation forms were returned to the CHD Managed Clinical Network Office.
Overall most of the comments were very positive and the majority of delegates felt the event should be held on an annual basis for refresher and updating purposes. Twenty-four delegates overall felt the course was excellent and nineteen stated in was good. There were no comments regards, ‘Average’/ Not So Good’ /or ‘Bad’
Some of the steps that delegates planned to take as a result of the course included:-
1) Disseminate current thinking and knowledge to colleagues in General Practice.
Review use of certain medication
Further training in cholesterol
Will apply knowledge to daily GP and GPwSI work
Appropriate 1 management of CCF and who to refer
Encourage further use of Ace inhibitors in IHD patient
Improve daily practice
Consider more carefully recommending Aspirin as primary prevention as no evidence
Check Phase II cardiac rehab in pats
Implement guidelines
Pass on knowledge to nursing.medical colleagues
Review Warfarin protocol
Review Statin/Aspirin/Clopidogrel use
Clearer management of range of cardiac conditions
Think about management of AF in the Practice
Review management of cardiac failure
Will think of heart failure NY classification and choice of drugs more.
Re-read notes
More appropriate risk management
Close monitoring of INR
Review management of heart failure
Read of SIGN guidelines on heart disease
Encourage colleagues to aim for BGH-2 guideline targeting
Update practice based on new guidelines
Appropriate 1 care management
Re-assess advice re. Warfarin
Consider audit heart failure treatment in Practice
Circulate main learning points to colleagues
Review patients with CF to ensure optimum treatment
Review patients with AF to ensure optimum treatment
Do an audit on cardiac failure and beta blockers
Review care of patients in Practice with heart failure
Stopping Digoxin
Put into practice new areas learned
Treat my cardiac failure patients more aggressively
Share information with work colleagues
Revise treatment protocol
Follow up on my own cardiac patients to ensure access to rehab.
Updated CPD
Arrange a computer reminder re “Stopping Clopidogrel”
Tightening of INR in AF
2) Better Referrals content
Further training in HF
D/W pharmacist re statins – usage with adverse effects, which to change to?
Apply the knowledge gained into Practice
Clopidogrel important for 1 year after S test
Re-assess Ezetimibe use
Improve my teaching
Review mix of CHD
Better referrals
INR aim 2.2
Refresh myself with current guidelines
Confident about treatment and referrals
Importance of cardiac rehab
Improve quality of referrals
Be more confident in dealing with cardiology problems
Appropriate referral
INR window
Re visit SIGN guidelines
Perhaps need to initiate beta blockers to patients who are not on them
Discuss target INR for AF with Practice Nurses who advise patients re. Warfarin dose
Better INR control
Treat my AF patients more aggressively
Can answer or provide information to patients which could not do previous to course
Cascade information to my Partners
Review of drug treatment within my LVF patients
New ways of explaining procedures to patients
Use the RACPC
More supportive of cardiac rehab
3) Improved patient management
Bring new knowledge to Practice
V +E check 3 month on Spironolactone
AF – INR 2.2
Ensure INR is 2.2
Become more aggressive with 1 prevention
More likely to now discuss with patients choice open re. PCI/surgery if appropriate
Management of heart failure
More confident in communicating with patients
Ensure ACE and B blockers
Check for ASSLGN scores
More confident now discussing interventions with patients and generally with cardiac conditions
To regularly update knowledge
Repeat visit in one year to next Symposium
Closer tight control on INR’s
Maintain AF patients on Warfarin as near to INR of 2.2 as possible
Other comments and suggestions
Yearly update welcomed.
Very good, informative presentations.
It was hoped the course would run again next year.
Thanks
Thanks were expressed to AstraZeneca and Servier for kindly supporting the event and providing an excellent buffet lunch.
Future Event
As many of the delegates felt it would be usual for an update on an annual basis, a provisional date for next year has been identified as 12 November 2008.
Sandy Reid
Network Manager CHD Managed Clinical Network
CHD & Stroke MCN Office, 1st Floor, Westholme, WoodendHospital Site, Aberdeen.
Tel: (01224) 5 56713
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