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Recipe Name

Identify eligible patients who are at high risk for dementia

Rationale

Use of multiple indicators may be able to detect those at high risk, but then management implications need to be considered. This includes the heightened risk of carer burden, but challenges present with approaching carers.

Target

Clients  that are not coded with a diagnosis matching the Dementia definition, who:

are coded with a diagnosis of depression, AND

are recorded as a smoker,

AND

are coded with a diagnosis matching the Diabetes definition, OR

are coded with a diagnosis matching the Cardiovascular Disease definition, OR

have a stroke recorded at any time, OR

**have had an Absolute Risk conducted in the last 2 years and the result has been recorded as High

CAT Starting Point

  1. CAT Open – CAT4 view (all reports) loaded.
  2. Population extract loaded and extract pane "hidden".
  3. Optional Only* : Filter Pane Open and under the 'General' tab, "Active Patients (3x < 2 years)" selected.


    *The decision to select either "Active" or "All" patient is left to the practice to make


CAT Start Screen



This recipe involves a number of different "OR" conditions. CAT4 filters normally are "AND" filters so we will have to use a cross tabulation to find the group of patients of interest. For more information on cross tabulation please see the relevant page(s) in the user guide here: Cross Tabulation Report

Firstly we need to exclude all patients who have already been diagnosed with dementia, and we are only interested in patients who smoke. This will be done by using the appropriate filters:

Condition Filter Tab

Select "No" for Dementia on the Mental Health tab. This will exclude anyone with a diagnosis of dementia recorded:


Risk Factors Tab

Select "Smoking" on the Risk Factor Tab. This will include only daily and irregular smokers:



Click Recalculate to apply the filters selected.

To find patients who have diabetes OR cardiovascular conditions OR who have had a stroke the Disease tab is used to select all bars relevant to the list of diagnosed conditions.



To add patients who have had an absolute risk assessment we need to use the the "CV Event Risk" tab:



Click on the 'Report' icon to apply our cross tabulation - for full details see here Cross Tabulation Report

 


This will show a list of all patients without a diagnosis of dementia meeting any of the selected criteria, some will meet more than one. The last columns in the table show the information on the diagnosed conditions and CV risk details.



To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”

 

The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up