A unique new guideline takes a 360-degree approach to managing heart disease in Canadian patients, with 83 recommendations in an easy-to-use reference. The guide is published in the CMAJ (Canadian Medical Association Journal)
“Physicians are rightly concerned that there are too many guidelines with too many individual recommendations to be practical and useful for daily use, especially in primary care. Typical patients with multiple illnesses require access to many guidelines at once, and some recommendations are not harmonized and often seem contradictory,” says Dr. Peter Liu, Scientific Director of the University of Ottawa Heart Institute and lead author of the latest C-CHANGE guideline. “We hope that this fourth update of the very popular C-CHANGE guideline will further meet the needs of healthcare professionals and patients, to prevent and treat cardiovascular conditions and associated brain health with a simple harmonized approach.”
An update of a 2018 publication, the Canadian Cardiovascular Harmonized National Guideline Endeavor (C-CHANGE) resource includes 48 new or revised recommendations of the 83, from 11 cardiovascular-focused guideline groups across the country.
Aimed at primary care and other health care providers, the C-CHANGE guideline contains actionable recommendations for Canadian adults with or at risk of cardiovascular disease, such as
- people with obesity, diabetes or hypertension;
- people with dyslipidemia, atherosclerotic vascular disease or heart failure; i
- people with atrial fibrillation, stroke or dementia.
It also includes health behavior recommendations for all Canadians to address risk factors for these conditions, including dietary, smoking and physical activity considerations.
C-CHANGE is about singing from the same song sheet. Our goal is to help health care providers understand the evidence for best practices, and if they can follow the guidelines, the health of the Canadian population could improve substantially.”
Dr. Sheldon Tobe, C-CHANGE co-chair and nephrologist at Sunnybrook Health Sciences Center
What is different from before?
More than 50% of the guideline contains new or revised recommendations from the previous version in 2018. This guideline is also more comprehensive and holistic in the care of patients with multimorbidity.
The partnership has expanded to include the Health Canada Dietary Guidelines, the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, and the Canadian Cardiovascular Society/Canadian Heart Rhythm Society guideline for the management of atrial fibrillation . It also includes a subsection on depression given its frequent coexistence and impact on cardiovascular disease.
“In the past 4 years, many of the national guideline organizations have released new evidence-based recommendations, from changes in medication management to new thresholds for lipid levels in secondary prevention,” says Dr. Rahul Jain, co-chair of C.-CHANGE and family physician at Sunnybrook Health Sciences Center. “We hope this resource will help primary care physicians keep up with many of the ever-evolving cardiovascular guidelines, so their patients can receive the best possible care.”
Source:
Journal of the Canadian Medical Association
Journal reference:
Jain, R. et al. (2022) Canadian Cardiovascular Harmonized National Guideline Endeavor (C-CHANGE) for the prevention and management of cardiovascular disease in primary care: 2022 update. Journal of the Canadian Medical Association. doi.org/10.1503/cmaj.220138.