Controlling risk factors
BY KIM ARCHER World Staff Writer
Monday, March 08, 2010
3/08/10 at 3:22 AM
As her 4-year-old son played peek-a-boo with a clinic nurse, Kimberlynn Robertson learned tips from a clinical pharmacist on how to better control her diabetes.
"I know when my blood sugar is high because I get real thirsty and use the bathroom a lot. And my vision will get blurry," the Tulsa woman said.
Robertson, 40, is one of 200 patients in a pilot project aimed at eliminating the disparity in death rates seen in some north Tulsa ZIP codes.
"The death rates from cardiovascular disease are higher in north Tulsa than the rest of the city and Oklahoma," said Dr. Mark Fox, an associate professor of internal medicine and pediatrics at the University of Oklahoma's School of Community Medicine in Tulsa.
He is also the principal investigator for the Heart Improvement Project, a joint effort of OU and the Tulsa Health Department.
Initially, the project has zeroed in on patients in just two ZIP codes: 74106 and 74126.
"We find those at high risk for cardiovascular disease and reduce barriers to care," Fox said. "Our short-term goal is to get risk factors controlled. Our primary goal is to reduce heart attacks, strokes or death."
In the year since the project began, health improvements have been measurable and compelling.
Only 30 percent of patients with high blood pressure had the condition under control in the beginning, but now 69 percent do, Fox said.
Improvements in cholesterol levels rose from 20 percent at the start to 72 percent, and diabetes control from 38 percent to 56 percent, he said.
"Preventive cardiology is like a jigsaw puzzle," Fox said.
The project focuses on high blood pressure, high cholesterol, diabetes and smoking — because all are conditions or behaviors that place people at high risk for heart disease, he said.
Michelle Lamb, a clinical pharmacist and faculty member at the OU College of Pharmacy in Tulsa, also plays an integral role in providing hands-on care for the patients, often acting as a health educator.
"I try to balance the science of what the best medication is and something they can actually afford," she said. "I feel we make a big difference because we get to spend time with the patients."
The Tulsa Health Department recruits patients through outreach at barber shops, beauty salons, housing projects and churches. The agency also provides case management.
"We set up health screenings and identify patients who might have high blood pressure, blood sugar or cholesterol," said Reggie Ivey, the department's interim director. "Many patients are either uninsured or underinsured. And some mistrust the medical system."
Case managers develop a rapport with patients and follow them closely to ensure that they get their prescriptions filled, attend follow-up appointments and don't experience side effects, he said.
"A number of clients have issues with paying rent or utility bills. We connect them with services to help them get their rent paid or that utility bill paid," Ivey said. "There are a laundry list of issues they may be dealing with that is causing them stress."
Robertson said she lost her job as a medical receptionist a year ago — and her health insurance, too.
"Before, my glucose meter would read high all the time," she said. Robertson's disease is now under better control.
The project is funded by a three-year $700,000 grant from the George Kaiser Family Foundation. The Tulsa Health Department provides intensive case management and recruitment services. And Neighbor for Neighbor has provided clinic space.
- high blood pressure
- high blood cholesterol
- being overweight or obese
More patients wanted
If you reside in either the 7 106
or 7 126 ZIP code and would like to
participate in the Heart Improvement Project, call
Rita Williams of the Tulsa Health Department at
Kim Archer 581-8315
Dr. Michelle Lamb (left) looks on as Kimberlynn Robertson is examined by Dr. Mark Fox last week during a clinic visit at Neighbor For Neighbor in Tulsa. Fox is the principal investigator for the Heart Improvement Project, a joint effort of OU and the Tulsa Health Department focusing on patients from two Tulsa ZIP codes. MICHAEL WYKE / Tulsa World
Kimberlynn Robertson talks with Drs. Michelle Lamb and Mark Fox during a clinic visit at Neighbor For Neighbor in Tulsa. Robertson is part of the Heart Improvement Project, a joint effort of OU and the Tulsa Health Department to help people who have a high risk of heart disease. MICHAEL WYKE / Tulsa World