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Doctors' Health Partnership

What Is The Doctors' Health Partnership (DHP)?
Why Does Seacoast Integrative Medicine Participate In The DHP?
What Clinical Guidelines Does The DHP Follow?
What Are The Clinical Goals For Patients With Diabetes Or Diabetes And Cardiovascular Disease?
What Are The Clinical Goals For Patients With Cardiovascular Disease?
What Is My Role In The DHP?

What Is The Doctors' Health Partnership (DHP)? 

Wentworth Health Partners Seacoast Integrative Medicine participates in the Health Partners of New Hampshire and Wentworth-Douglass Hospital Doctors' Health Partnership, a chronic disease care model designed to improve the management of clinical outcomes of patients with diabetes and/or cardiovascular disease. Our physicians are committed to partnering with our patients to work towards minimizing the complications of diabetes and cardiovascular disease with regular visits and blood work. Specifically, the program tracks, monitors and manages patients with diabetes and/or heart disease with the goal of decreasing the incidence of hardening of the arteries, heart attack, foot ulcers and other complications through regular visits, blood work and lifestyle change counseling. All patients with a qualifying diagnosis will be tracked and monitored through this program by their Primary Care Provider.

Why Do We Participate In The DHP? 

Diabetes is an epidemic in the United States. The number of patients with diabetes is currently doubling every 10 years. Adults with diabetes are two to four times more likely to develop heart disease than adults without diabetes. Complications of diabetes include heart disease and stroke, high blood pressure, blindness, kidney disease, amputations, complications of pregnancy and increased susceptibility to other diseases or illnesses such as pneumonia and influenza. 

Heart disease is also an epidemic in the United States. Cardiovascular disease causes a hardening or narrowing of the arteries that supply oxygen. Decreased flow of oxygen to the heart may lead to a heart attack and decreased flow to the brain may cause a stroke. Narrowing or hardening of the minor arteries in the legs can lead to leg pain.  In addition, cardiovascular disease may cause enlargement of the major blood vessels in the chest or abdomen, possibly causing them to rupture, resulting in death. In addition to the physical complications and deaths resulting from diabetes and cardiovascular disease, these two diseases are responsible for significant expenditures, not only through direct medical costs but also indirect costs such as disability, work loss, or premature death. 

What Clinical Guidelines Does The DHP Follow? 

The Doctors' Health Partnership utilizes evidence-based clinical standards of care, such as the American Diabetes Association guidelines in implementing best care practices for the management of patients with diabetes and National Cholesterol Education Program's clinical guidelines for managing patients with diabetes and cardiovascular disease. Overall, the program's goal is based on exceeding the standard of 40% of patients at goal for defined metrics as established by the National Committee on Quality Assurance.

Specifically, patients with a diagnosis of diabetes, either type I or II, will be monitored on three metrics: blood pressure (a measure of the pressure of the blood against the walls of the arteries), hemoglobin A1C (a measure of the average control of blood sugar over a three month period) and LDL (a measure of "bad" cholesterol). Patients with cardiovascular disease will be monitored on two metrics: blood pressure and LDL. Patients with both diabetes and cardiovascular disease are monitored on all three metrics: blood pressure, hemoglobin A1C and LDL. In addition to blood work, patients with diabetes should anticipate having routine foot exams, diabetic retinal exams, and albumin screenings.

Clinical Goals For Patients With Diabetes or Diabetes and Cardiovascular Disease

Hemoglobin A1C < 7.0%

LDL < 100 mg/dl

Blood Pressure <130/80 mm/Hg

Clinical Goals For Patients With Cardiovascular Disease

LDL < 100 mg/dl

Blood Pressure <140/90 mm/Hg

What Is My Role In The DHP?

If you have been diagnosed with diabetes, cardiovascular disease or both, we encourage you to work with your Primary Care Provider and the practice staff to ensure these recommended guidelines are met by scheduling regular appointments and obtaining lab testing per the direction of your physician. Together, you and your Primary Care Provider can work to avoid the complications associated with diabetes and cardiovascular disease. If you have any questions regarding your diagnosis or the Doctors' Health Partnership, please do not hesitate to contact a member of the clinical staff or schedule an appointment with your Primary Care Provider.

For more information on diabetes and your personal risk factors visit the American Diabetes Association.

©2009 Wentworth-Douglass Physician Corp., PO Box 458, Dover, NH 03821-0458