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HIGH-RISK AND CHD-DIAGNOSED
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HIGH-RISK AND CHD-DIAGNOSED
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Impacts: The economic burden of mental illness in Canada in 1998 was estimated at $4.7B in direct costs (hospital & institutional care, physician care, and prescription medications) and $3.2B in indirect costs (short-term sick days, long-term disability, and premature death). 15 People with mental retardation have a life-long handicap that produces an enormous social, emotional and financial burden on the families and communities in which they live. The lifetime cost in 2003 dollars for a person with MR in the USA was estimated to be more than $1M greater than that of an unaffected person. 16 It has been established that with. | Comprehensive systematic search to July 2002 plus selected update searches to December 2003 as advised by review groups 2 HIGH-RISK AND CHD-DIAGNOSED Everyone at high risk of developing coronary heart disease and all those who have been diagnosed as having the disease should have access to a multifactorial risk assessment and be offered an appropriate treatment plan. Patients at high risk of coronary heart disease are defined as those with a 10 year coronary heart disease risk of 30 i ii. i. National Assembly for Wales. Chapter 5 The implementation of Standard 2. In Tackling CHD in Wales Implementing Through Evidence. Cardiff National Assembly for Wales 2001 http www.wales.nhs.uk Publications coronary-heart-disease-e.pdf accessed 22.12.03 ii. Department of Health. Chapter 2. Preventing coronary heart disease in high risk patients. In National Service Frameworkfor Coronary Heart Disease. London Department of Health March 2000 http www.doh.gov.uk nsf coronary.htm accessed 22.12.03 National Service Framework National Assembly for Wales. Tackling CHD in Wales Implementing Through Evidence. Cardiff National Assembly for Wales July 2001 . .all those included on primary care CHD management systems will have been offered a Multifactorial Risk Assessment and an appropriate treatment plan. key action 9 Which instruments have been validatedfor multifactorial risk assessment .each Primary Care Team must develop an opportunistic screening programme for CHD risk factors amongst the practice population. keyaction6 Which are the best screening aids The statements The evidence 2.1 Risk assessment in primary care 2.1a. The Framingham risk model for the prediction of CHD mortality rates provides a reasonable rank ordering of risk for white individuals . However prediction of absolute risk is less accurate and currently recommended risk scoring methods derived from the Framingham study significantly overestimate the absolute coronary risk assigned to men in the United Kingdom . .
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