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Good afternoon and welcome to this webinar which is part of the share the pressure series, apologies. I've just got a jet going out overhead which is perfect timing. Just as we start the webinar share, the pressure is a project which is aiming to address high BP amongst Black African and Caribbean people using a shared decision making tool. This project is fully funded through a grant from the Burdette Trust for Nursing and involves the four organizations that you see listed at the bottom of the slide. There we have the race equality, Foundation, Smart Health Solutions, which is ourselves providing the education program element, younger lives and BP. UK. If I've not met you before, my name is Joanne Whores. I'm the clinical director of Smart Health Solutions. I'm a nurse consultant by background specializing in cardiovascular disease and I have a number of other roles and responsibilities as well. And what I'd like to concentrate on today is talking about how we could use, share the pressure to complement the BP at home program. Now, the project that we are doing currently with share the pressure is aimed specifically at Southeast London, but it's rela to everyone and we will be looking to roll this out further another apology for background noise. One of my dogs having a really big drink, the joys of working from home folks. So, um, hopefully you have found the chat box. Um If you would like to say hello in, introduce yourself where you're from or just let me know you can hear me. That would be fabulous. So that I know who's with me as well as those of you who are joining me live on the webinar today. This session is also being recorded. So welcome. If you are watching on demand a later date, now if you are watching on demand, you won't be able to see the chat and you won't be able to participate in the chat. So if questions come through, I will read them out just so the people who are watching on demand will know what we're talking about and apologies to those of you who with me live who will be able to see it all as it's happening. So uh training program, um it's not just myself, you may have already met Michaela and David and I'll tell you a bit more about our overall offering and what other other resources we have available towards the end of this webinar. Now you've found your way onto medal. Congratulations. If it's your first time and if it is your first time, they do have a look and see what else is available? We absolutely love working with Medal. It's an Incredibles platform and just an amazing resource for everybody. And it's, it's free to access for everybody. So um if you haven't already found them, there are a couple of little buttons to slide across one that will give you access to catch up content and there are a few fliers. There'll be this slide deck that you'll be able to see afterwards as well. Well, if you wish and also want to generate your certificate of attendance that you'll be able to use to pop in your portfolio or your for your revalidation, whatever you need that for, if you have any issues, problems accessing things on medal you'll see in the bottom right of your screen. I can see it now on mine, we have a little chat box there. If you click on there, that will take you through to the lovely folks that medal will help you with. Um any problems that you may have with accessing the bits you need high cut era. Lovely to have you with us. Um um So let's have a move on and, and do keep introducing yourselves. It's always good opportunity to perhaps connect with others that may or may not be in your area or could be in different areas around the world. So let's kick off with why we're interested in blood pressure and I'm sure you kind of already know that and that's why you're here that I'm coming for you from England at the moment. And here in England, high BP effects more than a quarter of all adults in England and affects more people as we get older. And it represents the third biggest risk factor for premature death and disability after smoking at a poor diet. Now, it's one of those things that's quite unfair in that it does tend to pick on people. There are a lot of health inequalities associated with high BP and people that live in the most deprived areas in this country are 30% more likely than those in the more affluent areas to have high BP. And we know that um many, many heart attacks, at least half all heart attacks and strokes are associated with high BP. And it's such a major risk factor for the entire spectrum of cardiovascular diseases. Um And it's something that is so common and affect so many people. And it's something that when it's found and identified the diagnostic process is really quite simple and even better news is that we have all of the amazing treatment options and we know that lifestyle can make a massive impact on BP. Basically, we've got kind of everything that we need to be able to control BP and reduce the risk in people if we apply all of these things in the right way and our population are engaged with that. And that's where share the pressure comes in. Really? So why are we particularly looking at black population for this edition? If you like of share the pressure share, the pressure isn't completely new. We have run this before and it's based on using heart age as a driver for change and to communicate about risk with people. Um But this particular edition, we have made some changes, our colleagues at younger lives. It's that their their program they have developed, share the pressure using heart age. And we are specifically looking at how we engage with people of Black African and Caribbean descent because we know that ethnicity is a significant risk factor when it comes to cardiovascular disease as a whole. And we know certainly people from the South Asian back crowds are more likely to be at risk of diabetes and coronary heart disease. But we do know that high BP disproportionately affects black people of African or Caribbean descent. And as a direct result of that, we know that there is a higher incidence of stroke and end stage renal failure in this population. We also know from the data that black people may be less likely to come forward for routine screening and health checks. And this particularly the chaps, the men that are less likely to come forward. And even when a diagnosis is made, it seems that high BP is less likely to be controlled well in black people than it is in white people. Now, this is obviously not a great scenario to be in and it wasn't great in the first place. But we know that COVID 19 has only served to make this situation work. So we know that there is a group of people within our overall population who are more likely to be affected, less likely to be found and less likely to be treated. And we know that this is leading to more disease disability, poor health, ultimately premature death in this population. So we absolutely need to do something to address this inequality. So as part of our program, our colleagues at the Race Equality Foundation have held a number of focus groups with people from Black African Caribbean populations and just really trying to find out out from them, what some of the issues are around BP, around engaging with services to find high BP, to manage high BP. And really what was important to the group of people that we spoke to. And what we heard was that people were really keen on taking control of their own health. And that staying younger was an important factor. And for the people we spoke to, it really wasn't something that they wanted to or that they talked about generally was aging. Um And this, this this youthfulness was such an important thing. There was also a lot of myths around symptoms. Now, we know that most people that have high BP don't know, they've got high BP because they never have any symptoms. It's a silent condition and contributes to being a silent killer as well. And people thought that if you had high BP, you would be plagued with headaches, dizzy spells, faintness, there were all manner of symptoms that people thought that you would know if you had high BP, didn't realize that it was just often sitting there silently. People also wanted to know where they could go locally for support. So it's all well and good having national advertising, national organizations. But what does this mean to me, where can I go locally to get my BP check, to get information and to get support? People were also keen that by participating in anything relating to this, that it was anonymous eyes, people weren't really comfortable of giving their details and certainly not share ing their details. They just wanted to have that information for themselves that would be useful for them taking forward, but giving up lots of information and for that being shared was not something that people really wanted to do. We talked to people about lifestyle interventions and about tailoring information. So it would be culturally appropriate and relevant. And one of the things that we heard was that, you know, we often talk about um you know, cultural based diets and information. But actually for many people, what we do and what we eat, what we drink goes across cultures now, particularly for people who are multiple generations down the line from their original heritage. So it's important when we're talking about diet, for example, that we talk about all foods and that we don't purely focus on those traditional diets because that might not necessarily be relevant for some of our population today. So we've listened to that and our colleagues at younger lives have really listened to that when they were putting together this edition of Share the pressure and share. The pressure is a digital tool that's available accessible to anybody. And what it does is it will calculate based on the information that somebody puts in around their risk factors. BP being a key part of that also take into account your age, your gender, your ethnicity, your cholesterol, if you know it, um your height weight and all the information that we normally gather of people to calculate cardiovascular risk. And it uses our tradition, cardiovascular risk algorithms to be able to calculate a heart age and your heart age is the age of your heart based on your risk factors in comparison to your chronological age. And the idea is that by giving this personalized information in a way that people can understand that it helps with communicating what somebody's individualized risk will be and can therefore help support them to make decisions and make changes to improve their overall health and well being and reduce their risk. And this is underpinned by behavior change therapy. So there's lots of talk about motivation and readiness for change and all those kinds of things. And this all comes together to really promote shared decision making by empowering people and giving them the knowledge and the information that they need to be able to have more meaningful discussion's with healthcare professionals help to sign, post them to relevant sources of support and generally helped them to take control of their BP of their health and well being and stay years younger. And we know that that's something that's important to them. So where does BP at home fit into all of this? Um So BP at home has or is a national program was originally initiated in 12 Trailblazer sites around the country. And it involved um distributing BP monitors to eligible patient's facilitating them to remotely report their home BP readings. So we know a really important port part of diagnosing high BP is to have that element of home BP readings or ambulatory blood pressure readings. So we know what somebody's BP do is doing the rest of the time, not just when they come into a clinical situation, because often for any of us are BP will be higher when it's taken in a clinical setting than it is the rest of the time when we're going about our usual daily life. So it's really important we have that home BP monitoring element to it. So it's providing the monitor and providing that that vehicle and that facility for people to be able to report their home readings that would then generate alerts two clinicians when necessary. So if there was anything that really needed addressing, it would be picked up this way sooner rather than later. Certainly, if there was any rapidly accelerating BP in there and also facilitate the coding, the clinical coding. So this information finds its way into patient's clinical record and is there to be used to facilitate the relevant follow up and Axion based on those results. So by people doing their own monitoring, doing their own reporting of their results, gathering that information really helps to promote self management and people having that awareness by seeing day in and day out what's going on with their BP where that's sits feeding that in and just getting people to really take control a more charge of monitoring their BP as well as what they want to do about it. And that very much sits in line with what we're trying to do with share the pressure. Now BP at home is being rolled out across the country, not everywhere has access to it yet. Now, we are particularly focusing on Southeast London for this particular phase of blood pressure at home because that's where we've had the funding to roll this out. There is a particular need, but there will be lots of need around the country. So, don't worry if you're not from South East London or this isn't the area for you, this will be relevant to you. Um And if you don't know about it, do you have a Google, read up on it and see what it's all about. It's a fantastic program, but even within South East London itself and it will be the same in other areas. Well, there is a local variation, local initiatives that are accompanying and enhancing the BP at home offer. So for example, in Bromley, what they are currently looking at doing, they've been piloting remote BP monitoring hubs within primary care networks, you using BP at home. So distributing BP monitors where needed, but really bringing PCN S together to identify patient's who would benefit from self manage management and self monitoring of the BP. Giving them the means to do that um supporting with how to take your BP and how to feed this information in. So using remote pathways such as a QRX in the area, but also having the availability of telephone and email support of people being able to feed in their results that way if it suits them. And so it's facilitating the pcs to work together to develop these remote monitoring tubs, but also establishing shared systems for collecting the data for reporting, managing this initiative and embedding it within the existing workforce within the PCN So there's lots of benefits to be had there. Now, this is just one example and we are going to be adding this to our pool of resources on our share the pressure educational resource page as a bit of a case study. And we'll try and put some contact details in there if we can so that you can find out more about that because it's all about the share ing of the learning to get these things rolled out and learn from each other rather than reinventing wheels all the time. So how could this work to bring these two together? Well, if you've got people who are remotely monitoring their BP, they're going to find out what their readings are, they're going to feed them into their clinical system. We've got that communication with them anyway. So it would be really easy to be able to share the link or we are, we've got QR codes. I think we're currently updating those because there was an issue with the last ones that could be sent out to people. They could use the QR codes. We are developing waiting room posters, something that could be emailed out could be sent out via text message to direct people to the share the pressure site and they will then go through the process of share the pressure and I could show you a little screenshot for that. Ideally, I'd take you through live the system, but I'll make sure that you have the links to be able to take you through and give it a whirl. But by going through, share the pressure, it will give people the information that they need to be able to go back and have discussion's with their health care providers about what to do about this BP. So the stuff that they can do themselves around any lifestyle changes, but also help prompt them in terms of thinking about any decisions around medication, whether they're interested in medication, whether they're not different types of medication available, and just really trying to prepare people for their consultation. So they're go equipped with questions to be asked and some of the information that's going to be relevant to them. And we know that using heart age as a vehicle for communicating cardiovascular risk works, we know from the studies there was the original study of this was actually done in Spain. Now it was done with the Caucasian population and by using heart age as a means of communicating risk, those people that were involved in that who had their heart age, they did really well in terms of making lifestyle changes and reducing their cardiovascular risk. And they did better than people who have had their risk communicated in more traditional way. So looking at their percentage risk of having a heart attack or a stroke over the next 10 years, for example, or people that didn't have their risk communicated with them at all. So we know that it works, but we don't know about this specific population, which is why we are running. Share the pressure looking to engage specifically with black people because we know of this disproportionate burden in this population. It's something that we must address and do whatever we can to reduce this inequality. So there's a really opportunity here to improve outcomes for this population. And as I say this, this episode, this edition of Share, the Pressure has been tailored with um culturally appropriate imagery and information that we hope is going to appeal more to this population and hopefully make a difference to them. So, within um are smart health solutions website, we have a welcome to share the pressure page. If you go to our website, um smart health solutions dot co dot UK, you will be able to click on the image for share the pressure and it will take you to the page that you can see now that will tell you about it. We have educational resources there for healthcare professionals and this is where you'll find your links to this webinar on demand and others. There's resources for patient's there as well. And we've got some interactive quizzes that people can participate in, see what they know what they don't know about um BP. And it also provides the link directly to the share the pressure site that will take you through. So do have a go this is what the front page looks like. And it will take you clicking on that pink button to a quick assessment that will ask you about your risk factors. So your age, your gender, your ethnicity, your BP. And of course, people will have that. If they've been participating in the BP at home initiative, it will ask about cholesterol. So it will ask all of the things that it asked about if you don't have those readings to put in, what it will do is generate an average for your age, gender and ethnicity. So you can still do it, but it won't be as accurate as it would be. And it will suggest that if you don't know your cholesterol that perhaps it's worth getting that checked, directing people to the NHS health check um or do have a link through to local services which were busy populating at the moment with colleagues from South East London to direct to the relevant place. Once you put in all of your information, it will generate your heart age in comparison to your chronological age. And for most of us, even if we struggle to understand what a 15% risk over the next 10 years of developing cardiovascular disease would mean. And whether that's a good thing, a bad thing or whatever is our glass, half full, half empty, most of us will be able to understand that if we are say 49 in my case, but I have a heart age of 56. I think that doesn't sound too great instantly. You've got that idea that my heart is older than I am. That's probably not a good thing. Is there anything if I'm interested that I can do about that? It will then take you through a series of questions asking whether you are confident and motivated to go to the next stage, whatever that may be. So for people that have just had a one off BP taken at a health event or in a pharmacy or in a supermarket or whatever, it will direct them to perhaps go and get further readings done. If that reading is high, if someone does it and they don't know their BP, it will direct them to places where they could get their BP checked. If it's someone who's been doing BP at home and has reported their home based readings, then it will take you through. So based on the readings that you've provided that appear to be if they are high, these are the things that you could consider thinking about. And so it will take you through some lifestyle information that's relevant around um, dietary changes, around physical activity, around smoking, um and around, you know, a variety of things, alcohol and then what it will tell you, um, at the click of a button is how much difference you could make to your heart age by making changes to your lifestyle and that can be a real motivating factor for people. So it's a really useful tool that we have in there as well as generating links to local resources. And I say we were still developing those at the moment. It will also direct you to the next relevant stage. Um It will ask what you're interested in to help personalize that to you. And it will also generate suggested questions for yourself and for your health care professional. So what kind of things when I go and see my pharmacists, my nurse, my GP, what are the sort of things that I might want to ask them? Um be that about lifestyle changes, monitoring medication, follow up anything that's in relation to BP. So it really helps to provide a virtual coach to people to then lead them to have more of a say and share in the decision making. And we know so that shared decision making leads to improved outcomes for patient's. And it's also really helpful to us as healthcare professionals. If our patient's are equipped with the knowledge that they need to be able to make their decisions, hopefully will make for more effective and efficient consultations when we do see them. So um my call to action to all of you um is to go and have a look, have a look at, share the pressure, test it out on yourself, have a go test it out in your family, see what you find out, see what you think and just see whether you think this would be something useful to incorporate in your practice. Either too, signpost, patient's too by providing the link, the QR code, the posters, the flyers that whatever or whether it's something you might even decide to do it with them and go through it with them to find alternative ways of communicating cardiovascular risk to people to help facilitate that change. We have got our share the pressure community of practice, live up and running on our website and by joining this and anyone can join now, feel free. There is some where you can sign up and give us your details so that we can notify you in any new resources becoming available when we have any new webinars coming up, etcetera, etcetera, or you can just float around in there anonymously, if you would prefer to do that, it's entirely up to you. We have a series of webinars available from the basics of understanding what BP is through to talking about medicines for managing high BP. We've got a more detailed webinar that will take you through step by step, how to use the heart age tool, how to use the share the pressure website and exactly what comes up each time. We've also got a series of podcasts available in there. So if you're not someone that has the time or the inclination to sit and watch your webinar. There's something you can pop in your ears while you're doing the gardening, lying on your sun bed, uh in the garden. I mean, of course not an actual sun bed because we all know those aren't great for our health, walk in the door, cooking the dinner, whatever. There's podcasts there that you can listen to and there are more podcasts to come. There are further resources on there. There's links to the fantastic guidance that the clinical Effectiveness Group in Southeast London have put together around detection of management of high BP as well. So there's loads of stuff in there that you can tap into, that could be useful to you um in your mission to improve the management of BP in your population. So in summary, share the pressure can be used to really enhance the BP at home program and knowing your heart ege can be a great motivator for people and a gray facilitator for change. It can be used with or without healthcare professionals. So we could do it with them in a clinical setting if we wanted to or we could sign post and people could go home and do this on their own and come back to us if they have any questions, it's not going to cure the world. It's one part of the journey. It's another tool to have in our toolbox when we are trying to support that. Certainly here in England alone. That quarter of all adults that have got high BP. But we know that this is something that affects people all around the world. And increasingly so as we grow to an older age and continue to have less than healthy lifestyles, in many cases, do have a look and see what you think and join us for more sessions, there will be more life sessions coming up. So if there's anything that floats your boat, then please do join us. We would love to see you again. That brings us to the end of the presentation element. Um The chat box is open here. Please do pop in if you have any questions that you would like to ask or any feedback, um lots of stuff available for us and we would love to hear from you. So, you know, do do sign up if you would like to, I am gonna pop the feedback form here into our chat box as well. If you would be kind enough to provide us with some feedback as always on this webinar and whether it's useful or not, it really helps us to develop new content and, and give you more of what you might like to hear about in the future. If so that would be really, really helpful. So thank you to everyone that's saying, thank you. I really hope that's been useful to you and giving you a little bit of a flavor of what we're doing. With share the pressure, we um will be evaluating everything that we do. And of course, this will be part of our evaluation of healthcare professionals attending and how um useful they found it. We're also evaluating the use of the share the pressure tool and we're measuring people's motivation levels, people's confidence levels because obviously we're not doing anything that's individualized, it's all anonymous. So it's, we're, we're looking at people's self reporting of how useful this is going to be. So we will be publishing that later on in the year. We've got a little bit longer of this pilot program to run. But if you think you're, if you're not in Southeast London and you think that this would be something that you would be particularly of interest in your area, then again, do you give us a shout, it's available in there for anyone to use and you know, we may be able to help with something bespoke for your area in the future if that would be of interest. So do give us shout, I'm sorry, Debbie, the feet back form is not opening for you. If it's not working from here, you will get an email follow up, um requesting feedback. Hopefully you'll be able to provide it that way. If not, then do just click on the chat box in Medal and um they will be able to help you to make sure that we can get your your valuable feedback. So thank you for letting us know about that. We'll, we'll try and see what's happening and hopefully it's working for other people. Well, if there is nothing further, thank you, Debbie. Then I'm gonna sign off and give you back the rest of your day. Thank you so much for joining me as always. It's a delight to have you with us. And if you're watching on demand and any questions come back, then drop us a line through the contact button on our web page and we will be very happy to follow up with you. Have a wonderful rest of the day. Look after yourselves, take care and hope to see you again soon. Bye bye. Yeah.