Independent Evaluation of RHASP Pilot Outlines Strong Case for Extending the Programme >

RHASP Programme’s Effectiveness in Preventing Heart Attack and Stroke is Proven - Target of Halving Event Rates of Heart Attack and Stroke in High Risk Cardiovascular Patients is found to be Achievable

Dublin, February 18th, 2005

An independent evaluation of RHASP (Reduction of Heart Attack and Stroke through Prevention) prepared for the Department of Health & Children has identified a number of clinical outcomes and benefits to the healthcare system delivered through RHASP which make a strong case for continuing the programme beyond its initial pilot phase. The report by Professor John Cairns, Professor of Health Economics, London School of Hygiene and Tropical Medicine, was launched this morning in the Royal College of Surgeons by the Tánaiste and Minister for Health and Children, Mary Harney, T.D.

Key findings of the evaluation report highlight that RHASP has been proven to be effective in addressing cardiovascular disease, one of the most critical issues in healthcare in Ireland with 41% of all deaths in Ireland in 2001 resulting from cardiovascular disease.

The RHASP programme, a unique collaboration between the Department of Health, Beaumont Hospital, General Practice and dabl Ltd, has been the subject of an 18 month pilot scheme in six general practices on the north side of Dublin city. The independent report, published today, analyses the results of the pilot and considers how the RHASP programme could be used more broadly to meet the growing needs in the area of cardiovascular care.

Commenting at the launch of the evaluation report, the Tánaiste and Minister for Health and Children, Mary Harney T.D. said: “We have clearly stated our objectives to reduce the death rate from cardiovascular disease in the under 65 age group by 30% in the next ten years. The results of the RHASP pilot indicate that this programme can play a role in helping us to achieve these goals. The model of collaboration and the innovative use of IT which supports the value for money objectives also provide strong arguments for ensuring that this programme should be considered as part of any future strategies to address the continued challenge of cardiovascular disease.”

Some of the key outcomes identified by the report author include:

RHASP has achieved its primary objectives with the potential to halve the occurrence of stroke and heart attack. On this basis it is possible to estimate that if 20,000 high-risk patients in the Eastern Regional Health Authority were managed within the RHASP programme over a 10 year period, this would result in the prevention of 1,500 heart attacks and 750 strokes.
RHASP clearly represents an innovation that is highly consonant with the general thrust and the detail of the cardiovascular strategy particularly with respect to its role in the detection of those at high risk and in dealing effectively with those who have clinical disease.
RHASP is a good example of an effective programme for the detection and management of those with high cardiovascular risk in general practice – utilising evidence based guidelines for treatment and shared care that give quality outcomes in an appropriate treatment setting.
RHASP utilises IT innovation to good effect, is user friendly and helps bring together specialists, general practitioners, nurses and patients in a collaborative approach.

Dr. John Cairns also recommends that consideration be given to how RHASP could support other cardiovascular initiatives. Specifically he recommends that an agreed number of Heartwatch practices should use the RHASP ICT model to allow for a proper empirical test of the possible synergies that would benefit healthcare as a whole.

Consistent with policy concerns, RHASP was developed with the core objective of integrating best clinical practice with innovative healthcare management systems to target cardiovascular disease in a value for money framework. The evaluation of the pilot highlighted the strength of the initiative in a number of areas including; clinical outcomes; binging evidence based medicine from research to practice and the role of ICT in linking primary and secondary care. A series of recommendations are included within the final evaluation report which will now be considered by the Department of Health and Children.

Commenting on the success of the pilot the consultant who co-ordinated the RHASP Pilot Project at Beaumont Hospital, said: “The RHASP Pilot study results clearly indicate that RHASP is a particularly effective programme for the detection and management of patients at high risk from heart attack and stroke in general practice. The evaluation of the pilot supports the view that the opportunity to reduce events of heart attack and stroke through evidence-based prescribing of cardio-protective medication and by reducing and maintaining reductions of blood pressure and cholesterol to pre-determined goals, together with life-style changes, is realistic and achievable. A strong argument now exists for the extension of the project so that it can play a role in helping to tackle the continuing epidemic of cardiovascular disease.”

He continued: “We welcome the recommendation from Dr. Cairns that consideration should be given to deploying the RHASP ICT model in an agreed number of Heartwatch practices. I am of the view that this could be beneficial for all parties interested in tackling CVD.”

Mr. Bill Rickard, Managing Director, dabl Ltd said: “The fact that the role played by RHASP in introducing IMT into the general practice was highlighted as part of the final evaluation is welcomed. We have seen many cases where the introduction of the dabl system has led to wider use of IT in general practice, contributing to an overall improvement in efficiencies. The management system can play a significant role in helping to improve a wide range of issues in the health service and we look forward to the RHASP model being used in other parts of the healthcare system.”