Comparison of primary care models in the prevention of cardiovascular disease - a cross sectional study

BackgroundThe Russian Federation has very high cardiovascular disease (CVD) mortality rates compared with countries of similar economic development. This cross-sectional study compares the characteristics of CVD-free participants with and without recent primary care contact to ascertain their CVD risk and health status.MethodsA total of 2774 participants aged 40–69 years with no self-reported CVD history were selected from a population-based study conducted in Arkhangelsk and Novosibirsk, Russian Federation, 2015–2018. A range of co-variates related to socio-demographics, health and health behaviours were included. Recent primary care contact was defined as seeing primary care doctor in the past year or having attended a general health check under the 2013 Dispansarisation programme.ResultsThe proportion with no recent primary care contact was 32.3% (95% CI 29.7% to 35.0%) in males, 16.3% (95% CI 14.6% to 18.2%) in females, and 23.1% (95% CI 21.6% to 24.7%) overall. In gender-specific age-adjusted analyses, no recent contact was also associated with low education, smoking, very good to excellent self-rated health, no chest pain, CVD 10-year SCORE risk 5+%, absence of hypertension control, absence of hypertension awareness and absence of care-intensive conditions. Among those with no contact: 37% current smokers, 34% with 5+% 10-year CVD risk, 32% untreated hypertension, 20% non-anginal chest pain, 18% problem drinkers, 14% uncontrolled hypertension and 9% Grade 1–2 angina. The proportion without general health check attendance was 54.6%.ConclusionPrimary care and community interventions would be required to proactively reach sections of 40–69 year olds currently not in contact with primary care services to reduce their CVD risk through diagnosis, treatment, lifestyle recommendations and active follow-up.

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Beliefs and knowledge of cardiovascular-related disease among uninsured primary care patients: A cross-sectional study

Chronic Illness ◽

10.1177/1742395317746469 ◽

2017 ◽

Vol 15 (1) ◽

pp. 41-50

Author(s):

Akiko Kamimura ◽

Maziar M. Nourian ◽

Alla Chernenko ◽

Naveen Rathi ◽

Michael-Ann Oslund ◽

...

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Cross Sectional Study ◽

Spanish Speakers ◽

English Speakers ◽

Sectional Study ◽

Medically Uninsured ◽

Cross Sectional ◽

Perceived Severity ◽

Primary Care Patients

Objective The purpose of this study was to examine cardiovascular disease-related health beliefs and how they are influenced by knowledge and a sense of community among uninsured primary care patients. Method This study was a cross-sectional study using a self-administered paper survey (January to April 2016). The study population included medically uninsured US-born English speakers, non-US-born English speakers, and Spanish speakers. Results Medically uninsured adults utilizing a free clinic (N = 374) participated in the survey. Increasing knowledge about major risk factors for developing cardiovascular disease helped enhance levels of perceived severity of cardiovascular disease and benefits of healthy diet and physical activity. Spanish speakers reported higher levels of perceived severity of cardiovascular disease but lower levels of knowledge compared to US-born or non-US-born English speakers. Conclusion Spanish speakers may need different approaches to promote cardiovascular disease prevention due to their higher levels of perceived severity of cardiovascular disease but lower levels of cardiovascular disease-related knowledge compared to English speakers. Developing a healthy “community” in a clinic setting may be effective to promote cardiovascular disease-related health for underserved populations.

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Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2013-002808 ◽

2013 ◽

Vol 3 (4) ◽

pp. e002808 ◽

Cited By ~ 93

Author(s):

Daniel J Smith ◽

Julie Langan ◽

Gary McLean ◽

Bruce Guthrie ◽

Stewart W Mercer

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Physical Health ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Low Levels ◽

Health Comorbidities

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Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-031281 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031281 ◽

Cited By ~ 5

Author(s):

Manel Mata-Cases ◽

Josep Franch-Nadal ◽

Jordi Real ◽

Marta Cedenilla ◽

Didac Mauricio

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

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