Contents
Interactive maps of pharmaceutical management of cardiovascular risk in New Zealand using linked national electronic data
Background
Cardiovascular risk management guidelines routinely recommend that preventive treatment with blood pressure-lowering and lipid-lowering drugs should be based primarily on patients’ pre-treatment predicted cardiovascular risk, rather than levels of individual risk factors. However patients at high predicted cardiovascular risk but ‘normal levels’ of blood pressure and blood lipids frequently remain untreated, while patients with raised levels of blood pressure or blood lipids, but low predicted cardiovascular risk are regularly treated. We aimed to assess the cardiovascular risk and drug treatment status of New Zealand adults and present these data in interactive maps to help clinicians and provider organisations improve the management of cardiovascular risk.
Methods
We created a 2013 national cohort of almost all New Zealanders aged 30-74 years without prior cardiovascular disease by linking multiple national health and other administrative datasets in Statistics NZ’s Integrated Data Infastructure(IDI), a secure repository of individual-level linked national datasets from government and non-governmental agencies. Each person’s 5-year cardiovascular risk was predicted at baseline using the New Zealand policy risk prediction algorithm and their use of blood pressure lowering and lipid-lowering treatment over the subsequent three years was determined using the national pharmaceutical database that documents dispensing of all prescribed drugs in New Zealand. We applied geographical maps and population cartograms for spatial representations at the regional and subregional levels. At the national level, we used pseudo space/attribute space to show 5-year CVD risk profiles for various population groups.
Findings
We present a ‘family’ of interactive maps visualising national cardiovascular risk profiles and dispensing of blood pressure-lowering and lipid-lowering medications at the regional land sub-regional level, using population cartograms, stratified by predicted cardiovascular risk, diabetes status, gender and ethnicity.
Interpretation
Interactive visualisations of big data through different types of representations and at different scales can provide a useful tool to identify disparities in management of diseases and implementation gaps, and support policy makers to reach areas and population groups in most need for interventions.
Interactive Online Atlases
- CVD medication dispensing in 2015
- History of CVD from the IDI
- History of Diabetes from the IDI
- Smoking percentage from the 2013 Census
- CVD medication dispensing atlas for HQSC