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Retrospective chart review of metabolic syndrome at the Regina Community Clinic

Retrospective chart review of metabolic syndrome at the Regina Community Clinic. Roseann Nasser MSc RD CNSD Research Dietitian Nutrition and Food Services. Outline. What is the Regina Community Clinic What is metabolic syndrome Purpose Methods Discussion/Recommendations

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Retrospective chart review of metabolic syndrome at the Regina Community Clinic

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  1. Retrospective chart review of metabolic syndrome at the Regina Community Clinic Roseann Nasser MSc RD CNSD Research Dietitian Nutrition and Food Services

  2. Outline • What is the Regina Community Clinic • What is metabolic syndrome • Purpose • Methods • Discussion/Recommendations • Strengths/Limitations • Implications for practice • Questions

  3. What is the Regina Community Clinic (RCC)? • Cooperative primary health service provider • Diverse clientele • Staff: physicians, nurses, counsellors, dietitian, optometrist, exercise specialist, x-ray and lab technicians, support staff • Minimum of 15 minutes with each client

  4. Metabolic Syndrome (metsyn) Metsyn: • Obesity • Dyslipidemia • Hypertension • Type II Diabetes

  5. Purpose The purpose of the study was two-fold: 1) to determine the number of clients admitted to RCC with metsyn, and 2) what were the treatment options offered to clients

  6. Methods • Retrospective chart review • September 2006 • 530 charts • Data collection: • Height, weight, waist circumference • Age, gender • Serum triglycerides, HDL, fasting glucose • Dyslipidemia, hypertension, diabetes, obesity • Medication, lifestyle treatments

  7. Methods – continued • Modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) • Any 3 or more of the following 5 features:

  8. Results • 289/424 charts met criteria • mean age 55 years • All clients had risk factors • (HTN,  BMI, TG,  fasting glucose, HDL) • 42/289 clients identified with metsyn

  9. ResultsClassification of Clients with metsyn by age (n=42) 35 29 30 26 25 19 Percentage 20 15 10 9.5 10 5 5 0 80+ 50-59 70-79 18-39 40-49 60-69 Age Group

  10. 50 40 30 20 10 0 Results Treatments offered by Physicians and Nurse Practitioner (n=40) Number of Clients Medication Referral to Referral to Dietary Physical Weight loss advice ES Advice Activity RD Advice Treatments Offered

  11. Results Registered Dietitian (n= 24) and Exercise Specialist (ES) (n=11) 30 25 20 Dietitian 15 Number of Clients ES 10 5 0 Weight Lipids Diabetes Pre- HTN Loss Diabetes Type of Referrals

  12. Discussion • The purpose of this study was to determine the number of clients at RCC with metsyn? • 42/289 (14%) identified with metsyn • What treatment options were provided to clients? • 40 offered treatments • Medication 83% • Registered Dietitian 48% • Exercise Specialist 24%

  13. Recommendations to RCC • Metsyn – obesity, hypertension, dyslipidemia, type II Diabetes • Lifestyle therapies are integral to the treatment • Have BP and waist circumference checked at every visit • List risk factors for metsyn on RCC screening tool • Regular follow-up needed

  14. Acknowledgements Students • Ka Man Cheung, Dietitian Candidate • Nicole Pulvermacher, Dietitian Candidate • James Smetaniuk , Dietitian Candidate Advisors • Heather Dzioba, Regina Community Clinic • Jean Coleman, Internship Coordinator RCC staff • Dr. Jerry Danielson • Dr. Robin McMaster • Myrna Williams • Melanie Schipper and Russ Down • the Medical Records staff Research and Development • Ali Bell • Dr. Elan Paluck • Research Showcase

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