 3rd
Dialogue
Watson: So, once a cardiovascular risk factor is detected, the
patient’s problem-list is re-arranged and the diagnosis CARDIOVASCULAR RISK
FACTOR/S is added. This means that this patient now belongs to the
monitoring group.
Holmes: Precisely. We will examine the monitoring process shortly
where we will see that it also includes, among other things, a constant
search for other cardiovascular risk factors.
W: And you recommend that the files of those patients for whom no
cardiovascular risk factors have been detected, be examined again in three
years time.
H: Yes. This is a recommendation based on a few assumptions. The
first is that approximately 70-80% of the primary-clinic- patients see a
doctor at least once a year and more than 90% at least once in five years
(8).
The second is that this interval approximates the intervals recommended for
screening for dyslipidemia, diabetes mellitus, and hypertension (3-5 years
until age 65 and then every 1-2 years) (9) (10) (11).
The third is that the primary care physician continues to use case finding
between screening cycles, and at the very least asks about life habits,
obtains a family history and measures weight and blood pressure. Are we
ready for the monitoring process?
W: On your heels Holmes.
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Monitoring
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