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{\footerf\pard\plain\f0\fs24\par}\pard\s16\qr\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Page 1\par\pard\s16\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 CARDIAC, HYPERTENSION, LIPIDS Disease Management Plan  - initiated by {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20\b <<Doctor:Name>>{\*\txfieldend}\plain\f0\fs20\b\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs12\b\par{\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20\b <<Patient Demographics:Full Name>>{\*\txfieldend}\plain\f0\fs20\b  , aged {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Patient Demographics:Age>>{\*\txfieldend}\plain\f0\fs20  \plain\f0\fs20\b  Date of Plan: \plain\f0\fs20  \plain\f0\fs20\b  {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Miscellaneous:Date>>{\*\txfieldend}\plain\f0\fs20\par\pard\s16\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Check list of recommendations\par\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat5\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat5\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat5\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat5\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat5\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\cell GOALS\cell\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\cell\cell\plain\f0\fs20\cell\intbl\row\pard\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Examination\cell IDEAL\plain\f0\fs20\cell\cell  \plain\f0\fs20\b Pathology\plain\f0\fs20\cell\plain\f0\fs20\b IDEAL\plain\f0\fs20\cell\intbl\row\pard\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b BMI: \plain\f0\fs20\cell BMI  20 - 25% \cell\cell Total Cholesterol\cell less than {\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c004c007c007c007c00310039007c0033002e0035007c0034002e0030007c0035002e0030007c0035002e0035007c0036002e0035000000}{\*\txfieldtext \plain\f0\fs20\b <<Target Total Cholesterrol>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|L|||19|3.5|4.0|5.0|5.5|6.5"}}{\fldrslt{\plain\f0\fs20\b <<Target Total Cholesterrol>>}}}}\plain\f0\fs20\cell\intbl\row\pard\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Blood Pressure\plain\f0\fs20\cell Less than 130 / 80\par\cell\cell HDL cholesterol\cell greater than 1\plain\f0\fs28  \plain\f0\fs20\cell\intbl\row\pard\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Exercise\plain\f0\fs20\cell 40 - 60 mins daily\cell\cell LDL cholesterol\cell less than {\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 230043005500530054004f004d0023007c004c007c007c007c00350035007c006c0065007300730020007400680061006e00200032002e0030007c006c0065007300730020007400680061006e00200032002e0035007c004c0065007300730020007400680061006e00200033002e0030007c006c0065007300730020007400680061006e00200034002e0030000000}{\*\txfieldtext \plain\f0\fs20 <<Target LDL>>}{\field{\*\fldinst { HYPERLINK "CUSTOM" \\l "|L|||55|less than 2.0|less than 2.5|Less than 3.0|less than 4.0"}}{\fldrslt{\plain\f0\fs20 <<Target LDL>>}}}}\plain\f0\fs20 .\plain\f0\fs28  \plain\f0\fs20\cell\intbl\row\pard\trowd\trgaph108\trleft0\trpaddl108\trpaddt0\trpaddr108\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx3141\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx5916\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx6501\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx8181\clvertalt\clbrdrl\brdrs\brdrw10\clbrdrt\brdrs\brdrw10\clbrdrr\brdrs\brdrw10\clbrdrb\brdrs\brdrw10\clcbpat6\cellx10080\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Diet:\plain\f0\fs20  \cell low  fat, salt, sugar & alcohol\par increase fibre, omega 3 oils\cell\cell Triglycerides\cell\pard\s16\intbl\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Less than 1.5 .\plain\f0\fs28  \plain\f0\fs20\cell\intbl\row\pard\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs12\par\plain\f0\fs20\b\ul Other\plain\f0\fs20  \tab\plain\f0\fs20\b\i Aspirin prophylaxsis recommended\tab{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 230043005500530054004f004d0023007c004c007c007c007c00340036007c005900650073005e007c004e006f007c0059006500730020002d002000620075007400200061006c006c00650072006700690063007c005900650073002000620075007400200050004800200062006c0065006500640069006e0067000000}{\*\txfieldtext \plain\f0\fs20\b <<asprin recommended>>}{\field{\*\fldinst { HYPERLINK "CUSTOM" \\l "|L|||46|Yes^|No|Yes - but allergic|Yes but PH bleeding"}}{\fldrslt{\plain\f0\fs20\b <<asprin recommended>>}}}}\plain\f0\fs20    \par\par\pard\s16\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 -------------------------------------------------------------------------------------------------------------------------------------------\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs12\par\plain\f0\fs20\b\ul MANAGEMENT\par\plain\f0\fs12\b\ul\par\plain\f0\fs20\b Self-Care Education\plain\f0\fs20   \plain\f0\fs20\b ""     ( \plain\f0\fs20\b\i Available from practice nurse \plain\f0\fs20\b )\plain\f0\fs20   \par\plain\f2\fs24 q\plain\f0\fs20   Hypertension\tab\plain\f2\fs24 q\plain\f0\fs20   Benefits of exercise & some statistics  \plain\f2\fs24 q\plain\f0\fs20  General diet advice\par\plain\f0\fs12\par\pard\s16\li567\tx567\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\plain\f0\fs20\b\i Others  include:\plain\f0\fs20  Reducing weight, Sterols, Why diets don't work, \tab Low carbohydrate diets,  Walking plan & pedometers,  Heartmoves CD, cardiomyopathy\par\plain\f0\fs12\par{\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 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}{\*\txfieldtext \plain\f0\fs20 <<Recommendations>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|M||S|167|Actions for Practice nurse: Record BP, weight, BMI, smokingCheck & record diet & exercise List education sheets givenReview exercise plan & weight if appropriate"}}{\fldrslt{\plain\f0\fs20 <<Recommendations>>}}}}\plain\f0\fs20\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Exercise\plain\f0\fs20\b\i  \plain\f0\fs20\b Plan: {\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 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}{\*\txfieldtext \plain\f0\fs20 <<Exercise plan>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|L||SU|212|Will think about increasing exercise|Will increase exercise - no specifications|Will increase exercise - consider 10,000 step meter^|Will aim to exercise every day - 40-60 mins|Currently believes exercises enough"}}{\fldrslt{\plain\f0\fs20 <<Exercise plan>>}}}}\plain\f2\fs24\par\plain\f0\fs20\tab\tab\par\plain\f0\fs20\b Diet Plan {\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c004d007c007c0053007c003100360039007c00570069006c006c00200061007400740065006d0070007400200074006f00200066006f006c006c006f0077002000640069006500740020007300680065006500740020007200650063006f006d006d0065006e0064006100740069006f006e007300200061006e006400200069006e0020000d000a0070006100720074006900630075006c0061007200200074006f00200072006500640075006300650020006600610074002c002000730061006c0074002c0020007300750067006100720020002600200061006c0063006f0068006f006c000d000a0054006f00200069006e0063007200650061007300650020006600690073006800200069006e00740061006b00650020006f00720020006f006d006500670061002000330020006f0069006c002000630061007000730020002600200069006e0063007200650061007300650020002000660069006200720065000000}{\*\txfieldtext \plain\f0\fs20 <<Diet plan>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|M||S|169|Will attempt to follow diet sheet recommendations and in particular to reduce fat, salt, sugar & alcoholTo increase fish intake or omega 3 oil caps & increase  fibre"}}{\fldrslt{\plain\f0\fs20 <<Diet plan>>}}}}\plain\f0\fs20\par\par\plain\f0\fs20\b\i Additional comments: - \plain\f0\fs20  \par\plain\f0\fs12\par\pard\s16\qc\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20 ----------------------------------------------------------------------------------------------------------------------------------------------\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs12  \plain\f0\fs20\b\ul Health Care Providers involved\plain\f0\fs20\b :  \plain\f0\fs20 (If > or = 2, consider +\plain\f0\fs20\b  \plain\f0\fs20\cb4\chshdng0\chcfpat0\chcbpat4 ITEM  723 Team Care Arrangement )\plain\f0\fs20\par\trowd\trgaph30\trleft0\trpaddl30\trpaddt0\trpaddr30\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx3212\clvertalt\cellx6424\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b\i Cardiologist\cell HMR\cell Other Allied Health: \cell\intbl\row\pard\trowd\trgaph30\trleft0\trpaddl30\trpaddt0\trpaddr30\trpaddb0\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx3212\clvertalt\cellx6424\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080{\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c0043007c0030007c0053007c0034007c004e006f006e0065000000}{\*\txfieldtext \plain\f0\fs20\i <<Cardiologist>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|C|0|S|4|None"}}{\fldrslt{\plain\f0\fs20\i <<Cardiologist>>}}}}\plain\f0\fs20\par\cell{\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c0043007c0030007c0053007c00310033007c004e006f007400200069006e0064006900630061007400650064000000}{\*\txfieldtext \plain\f0\fs20 <<HMR medication review>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|C|0|S|13|Not indicated"}}{\fldrslt{\plain\f0\fs20 <<HMR medication review>>}}}}\plain\f0\fs20\par\cell{\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c0043007c003100300030007c00530055007c00310033007c00440069006500740069006300690061006e003a0020004d0073000000}{\*\txfieldtext \plain\f0\fs20 <<Other Health Care Providor type and name >>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|C|100|SU|13|Dietician: Ms"}}{\fldrslt{\plain\f0\fs20 <<Other Health Care Providor type and name >>}}}}\plain\f0\fs20\cell\intbl\row\pard\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs12\b\ul\par\plain\f0\fs20\b\ul Initial Recommendation:\par\plain\f0\fs20 - Aim to improve above parameters (BP, lipids, weight, exercise)\par - Organise plan in conjunction with practice nurse\par\par\plain\f0\fs20\b\ul Subsequent management\plain\f0\fs20\par\plain\f0\fs20\b\i Review date DMP:\plain\f0\fs20  {\txfielddef{\*\txfieldstart\txfieldtype2\txfieldflags26}{\*\txfielddatadef\txfielddatatype2\txfielddata 230043005500530054004f004d0023007c0044007c007c007c00310030007c00200020002f00200020002f0020002000200020000000}{\*\txfieldtext \plain\f0\fs20 <<Formal Review Date DMP (725) > 3 months>>}{\field{\*\fldinst { HYPERLINK \\l "#CUSTOM#|D|||10|  /  /    "}}{\fldrslt{\plain\f0\fs20 <<Formal Review Date DMP (725) > 3 months>>}}}}\plain\f0\fs20  (at least every 6 months - Reminder Yes/No)\par\plain\f0\fs12\b\ul\par\plain\f0\fs20\b\ul Patient Agreement (for careplan)\plain\f0\fs20\b\par\plain\f0\fs20 I have agreed / my carer has agreed, to this Health Assessment and understand the recommendations above. I am happy for this information to be shared with any Health Care providers nominated above.\par\par\par Signed by Patient/ Carer\tab _______________________________________\par\par\par\pard\s16\qr\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Signed by GP\tab\tab _______________________________________       \page\plain\f0\fs20\b Page 2\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 CARDIAC, HYPERTENSION, LIPIDS Disease Management Plan (721) - initiated by {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20\b <<Doctor:Name>>{\*\txfieldend}\plain\f0\fs12\b\par{\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20\b <<Patient Demographics:Full Name>>{\*\txfieldend}\plain\f0\fs20\b  , aged {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Patient Demographics:Age>>{\*\txfieldend}\plain\f0\fs20  \plain\f0\fs20\b  Date of Plan: \plain\f0\fs20  \plain\f0\fs20\b  {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Miscellaneous:Date>>{\*\txfieldend}\plain\f0\fs20\b\par\plain\f0\fs20 Fact sheets for - Chronic disease management plans link:\plain\f0\fs20\b  {\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags0}{\*\txfielddatadef\txfielddatatype1\txfielddata 68007400740070003a002f002f007700770077002e006e00650076006400670070002e006f00720067002e00610075002f0069006e0066006f002f00630061007200650070006c0061006e0073002f0069006e006400650078002e00680074006d002300460053000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000}{\*\txfieldtext \plain\cs17\f0\fs20\ul\cf3 www.nevdgp.org.au/info/careplans/index.htm#FS}{\field{\*\fldinst { HYPERLINK "http://www.nevdgp.org.au/info/careplans/index.htm" \\l "FS"}}{\fldrslt{\plain\cs17\f0\fs20\ul\cf3 www.nevdgp.org.au/info/careplans/index.htm#FS}}}}\plain\f0\fs20\b\par\par\plain\f0\fs20 ------------------------------------------------------------------------------------------------------------------------------------------\par\plain\f0\fs20\b Measurements:\par{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 440049004100530054004f004c00490043003b004800450049004700480054003b005700450049004700480054000000}{\*\txfieldtext \plain\f0\fs20 <<Clinical Details:Measurements>>}{\field{\*\fldinst { HYPERLINK "DIASTOLIC;HEIGHT;WEIGHT" }}{\fldrslt{\plain\f0\fs20 <<Clinical Details:Measurements>>}}}}\plain\f0\fs20\par\par\plain\f0\fs20\b Family & Social History\par\plain\f0\fs20 Smoker:  {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Clinical Details:Smoking>>{\*\txfieldend}\plain\f0\fs20   Alcohol intake: {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Clinical Details:Alcohol>>{\*\txfieldend}\plain\f0\fs20\par  \tab\tab\par\plain\f0\fs20\b Current Conditions\plain\f0\fs20\par{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 410043000000}{\*\txfieldtext \plain\f0\fs20 <<Clinical Details:History List>>}{\field{\*\fldinst { HYPERLINK "AC" }}{\fldrslt{\plain\f0\fs20 <<Clinical Details:History List>>}}}}\plain\f0\fs20\b\par Past History\par{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfielddata 490043000000}{\*\txfieldtext \plain\f0\fs20 <<Clinical Details:History List>>}{\field{\*\fldinst { HYPERLINK "IC" }}{\fldrslt{\plain\f0\fs20 <<Clinical Details:History List>>}}}}\plain\f0\fs20\par\plain\f0\fs20\b Medications\plain\f0\fs20\par{\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Clinical Details:Medication List>>{\*\txfieldend}\plain\f0\fs20\par\plain\f0\fs20\b Allergies and Immunisations\par{\txfielddef{\*\txfieldstart\txfieldtype1\txfieldflags26}{\*\txfielddatadef\txfielddatatype1\txfieldbin\txfielddata 52000000}{\*\txfieldtext \plain\f0\fs20\b <<Clinical Details:Allergies>>}{\field{\*\fldinst { HYPERLINK "R" }}{\fldrslt{\plain\f0\fs20\b <<Clinical Details:Allergies>>}}}}\plain\f0\fs20\par\plain\f0\fs20\b Warnings: {\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20\b\i <<Clinical Details:Warnings>>{\*\txfieldend}\plain\f0\fs20\b\par Relevant Pathology:\par{\*\txfieldstart\txfieldtype0\txfieldflags26}\plain\f0\fs20 <<Summary:Investigation Results (Selected)>>{\*\txfieldend}\plain\f0\fs20\par\pard\s1\qr\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b\par\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs20\b Review No1 : item 725\par\plain\f0\fs20 (insert progress notes here)\par\par\plain\f0\fs19\par\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs18\cell\cell Recommended\cell Minimum\cell\intbl\row\pard\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Item Name \cell Item No\cell frequency\cell claiming period*\cell\intbl\row\pard\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Preparation of a GP Management Plan \cell 721\cell 2 yearly\cell 12 months*\cell\intbl\row\pard\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Preparation of Team Care Arrangements\cell 723\cell 2 yearly\cell 12 months*\cell\intbl\row\pard\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Review of a GP Management Plan \cell 725\cell 6 monthly\cell 3 months*\cell\intbl\row\pard\trowd\trgaph60\trleft0\trpaddl60\trpaddt20\trpaddr60\trpaddb20\trpaddfl3\trpaddft3\trpaddfr3\trpaddfb3\clvertalt\cellx5316\clvertalt\cellx6411\clvertalt\cellx7971\clvertalt\cellx9636\pard\widctlpar\intbl\pard\s16\intbl\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080 Coordination of Review of Team Care Arrangements \cell 727\cell 6 monthly\cell 3 months*\cell\intbl\row\pard\pard\s16\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\plain\f0\fs19\i\par * CDM services can also be provided more frequently in\loch\f0\hich\f0 \'92 exceptional circumstances\'92 \'96 where there has been a\par significant change in the patient\'92s clinical condition or care circumstances (such as development of co-morbidities\par or complications, deteriorating condition, illness/death of carer etc), that require a new GP Management Plan,\par Team Care Arrangements or review service.\plain\f0\fs18\par\plain\f0\fs20\b\ul\par\pard\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\tx10080\par }