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Type: Journal article
Title: The Green, Amber, Red Delineation of Risk and Need (GARDIAN) management system: a pragmatic approach to optimizing heart health from primary prevention to chronic disease management
Author: Carrington, M.
Kok, S.
Jansen, K.
Stewart, S.
Citation: European Journal of Cardiovascular Nursing, 2013; 12(4):337-345
Publisher: SAGE Publications
Issue Date: 2013
ISSN: 1474-5151
Statement of
Melinda J Carrington, Simone Kok, Kiki Jansen and Simon Stewart
Abstract: Background: A sustained epidemic of cardiovascular disease and related risk factors is a global phenomenon contributing significantly to premature deaths and costly morbidity. Preventative strategies across the full continuum of life, from a population to individual perspective, are not optimally applied. This paper describes a simple and adaptable 'traffic-light' system we have developed to systematically perform individual risk and need delineation in order to 'titrate' the intensity and frequency of healthcare intervention in a cost-effective manner. Methods: The GARDIAN (Green Amber Red Delineation of Risk and Need) system is an individual assessment of risk and need that modulates the frequency and intensity of future healthcare intervention. Individual assessment of risk and need for ongoing intervention and support is determined with reference to three domains: (1) clinical stability, (2) gold-standard management, and (3) a broader, holistic assessment of individual circumstance. This can be applied from a primary prevention, secondary prevention, or chronic disease management perspective. Results: Our experience with applying and validating GARDIAN to titrate healthcare resources according to need has been extensive to date, with >5000 individuals profiled in a host of clinical settings. A series of clinical randomized trials will determine the impact of the GARDIAN system on important indices of healthcare utilization and health status. Conclusions: The GARDIAN model to delineating risk and need for varied intensity of management shows strong potential to cost effectively improve health outcomes for both individuals at risk of heart disease and those with established heart disease.
Keywords: Disease management; prevention; prioritizing care
Rights: © The European Society of Cardiology 2012
RMID: 0030087282
DOI: 10.1177/1474515112451702
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Appears in Collections:Medicine publications

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