Adapting pathways to optimise treatment and provide holistic care

Resources embedded in the dashboard 

For each condition, the CVDACTION Dashboard help panel holds a range of resources to support clinicians and non-clinicians. These include a one page simple summary for each condition that captures the key elements of NICE guidance, and a separate button that links to NICE guidance and other resources. You can also find these resource packs here. There are also slide decks for each condition, designed to help clinicians with common challenges – the things that make implementation of guidance difficult in the real world such as statin hesitancy, second line therapies in lipid lowering, proteinuria management in chronic kidney disease and diabetes. 

The value of rapid clinical optimisation  

When treatment needs progressive titration to optimal levels (e.g. blood pressure medication), we suggest a process of rapid optimisation – for example reviewing the patients every two weeks or so and adjusting therapy until control is achieved. There is often no reason to wait longer, and optimising treatment quickly will reduce the patient’s risk quickly. If the patient is able to provide their own blood pressure readings, these follow up consultations can be virtual. Rapid optimisation where clinically appropriate will lead to quicker risk reduction for the patient and more rapid population health impact. The Proactive Care Frameworks provide links to some high quality trusted resources for patients to help them understand their condition and to self manage. 

Providing holistic proactive care

CVDACTION brings an opportunity not just to optimise clinical care but also to provide patients with more holistic proactive care – with structured support for education, self-management and behaviour change. These consultations delivered by members of the wider workforce in primary care, for example health care assistants, coaches, or care coordinators allow time to ensure patients feel heard, while providing key information and support to help them to live with and manage their condition. 

The Proactive Care Consultation guide embedded in the CVDACTION dashboard and the suite of Proactive Care Frameworks provide some great resources to help staff undertake these consultations – with knowledge bites, key advice, motivational interviewing techniques and trusted digital links for patients.  

You don’t need to have every member of the wider workforce in your team to take this approach. For example, if you only have one or two ARRS roles, focus on competencies rather than job titles. In this way, team members who lack some of the skills required can be trained to achieve the necessary competencies, avoiding the need to recruit to additional roles.  

For more details, you can visit our case study page.