INVADE

What is INVADE?

Stroke and dementia (a decline in brain function) are cerebrovascular diseases that can result in severe and permanent disability. Patients with this consequent disability will often maintain significant long term care needs. Care dependency is, for many people, an unimaginable and egregious fate. For the individual, this change results in a loss of independence and a potentially dramatic decline in quality of life. For our society, these long term care requirements place an enormous burden on our community, care systems, and financial resources.

The idea for project INVADE began in the district of Ebersberg. Through the experience of daily patient care, the area neurologists gained appreciation for the positive impact preventative medicine (control of risk factors) could have on the incidence (frequency of occurrence) of stroke and dementia. This simple, but powerful observation led to the design and implementation of INVADE: a project that will emphasize risk factor control to improve disease outcome.

One of these risk factors is hypertension. Today, many patients with hypertension remain inadequately treated according to the WHO and German high blood pressure guidelines. Because hypertension does not cause pain or specific symptoms, many patients are unaware that they have the disease. Of those individuals who carry a hypertension diagnosis, only some take their medications as prescribed. These shortcomings provide an opportunity for outcome improvement through enhanced risk factor control. This is the basis of the INVADE project design.

Project INVADE attempts to implements aggressive screening, recording, and treatment of known vascular disease risk factors, such as hypertension, hyperlipidemia, diabetes mellitus, tobacco use, atrial fibrillation, sedentary life style, obesity, hyperhomocystinemia, low intake of unsaturated fatty acids (i.e., omega 3), and excessive intake of saturated fats.

Project INVADE is a cooperative effort of:

• the physicians, who play a central role in the INVADE project
• AOK Bayern, without whom the project would not be possible
• the Department of Neurology and Psychiatry at the Technical University of Munich (Klinikum rechts der Isar)
• the Ebersberg Community Hospital
• the pharmaceutical industry, specifically, TEVA Germany
• the organization INVADE

• The frequency of occurrence (the incidence) of stroke and dementia in the treated patient population in the District of Ebersberg will decrease significantly.
• There will be a statistically significant decrease in disability (long term care dependency) in the treatment group.
• The total treatment costs (direct and indirect) will initially increase in the treatment group, but will then decrease to a level below that of the comparable control patient group.

The organization INVADE was founded early in the process of a two year period of preliminary work. Members of the chairman board are:

• Chairman: Hans Gnahn, M.D., private Neurologist in Ebersberg
• Vice-chairman: Claus Briesenick, M.D., private Neurologist and Psychiatrist in Baldham
• Treasurer: Ulrich Huntgeburth, M.D., family doctor in Grafing

INVADE is a non-profit organization. It serves as a liaison between the Technical University in Munich, private physicians, the AOK Bayern, the pharmaceutical industry, and pharmacies. The office headquarters for INVADE are located in Baldham (District of Ebersberg).

The model project INVADE relies the active involvement of patients. INVADE has therefore developed a "Health Pass" for participating patients. In this pass, individual risk factors are documented and treatment plans are outlined (see below link). The Health Pass includes an introduction to the project goals, recommendations for a sensible lifestyle, and a reminder to the patient to both implement these recommendations and to maintain appropriate follow up with their physician.