Results of a single center vascular screening and education program

Background. Vascular screening events have become a popular way to increase vascular awareness. Most screenings programs involve multiple locations on a single date and do not explore the local impact of screening. We evaluated the economic and community impact of the Dare to C.A.R.E. (DTC) program, a large, single center, continuous vascular screening and education program in Annapolis, Maryland. Methods. Between July 2000 and July 2006, DTC was offered free to the public for those over 60 or over 50 with risk factors of hypertension, diabetes, smoking, or elevated cholesterol. DTC consisted of a 2-hour educational lecture, completing a risk factor questionnaire, and testing blood pressure, carotid duplex, abdominal aortic aneurysm (AAA) ultrasound, and pedal pulse/ankle-brachial index (ABI). Mild disease (MD) was defined as 1% to 39% carotid stenosis or an ABI between .7 and .95; intermediate disease (ID) as carotid stenosis >= 40%, AAA >= 3 cm, or an ABI >= 0.7; and severe disease (SD) as carotid stenosis >= 60%, AAA 5 cm, or an ABI <= 0.5. Results were discussed with the participants and forwarded to their primary physicians. Questionnaire data and screening results were analyzed and local hospital data was examined to determine the effects of screening. Results. A total of 12,055 screenings were performed in DTC, 439 were excluded due to age less than 40 or repeat visits, leaving 11,616 unique patients for this report. Participation grew from 189 in 2000 to over 6400 in 2005. Age ranged from 40 to 95 (median 65 years) and females comprised 58.7%. Demographics included past smokers (51.3%), current smokers (7.3%), diabetes mellitus (10.6%), hypertension (46.7%), hyperlipidemia (49.4%), and prior myocardial infarction (MI) (11.9%). 47% participants had evidence of at least mild disease (MD) with intermediate disease (ID) found in 6.9% and severe disease (SD) found in 2.2% of patients screened. Statistical analysis showed a greater prevalence of ID and SD in patients with risk factors. Diabetes alone doubled the prevalence of disease in all age groups. Over 340 hospital vascular cases were identified in DTC patients in the first 5 years of the program. Conclusions. The Dare to C.A.R.E. vascular screening and education program is an effective way to detect early and significant vascular disease. It has a powerful effect on procedural and testing volumes.