High Variability in Implementation of Selective-Prevention Services for Cardiometabolic Diseases in Five European Primary Care Settings

(1) Background: Cardiometabolic diseases are the most common cause of death worldwide. As part of a collaborative European study, this paper aims to explore the implementation of primary care selective-prevention services in five European countries. We assessed the implementation process of the selective-prevention services, participants’ cardiometabolic profile and risk and participants’ evaluation of the services, in terms of feasibility and impact in promoting a healthy lifestyle. (2) Methods: Eligible participants were primary care patients, 40–65 years of age, without any diagnosis of cardiometabolic disease. Two hundred patients were invited to participate per country. The extent to which participants adopted and completed the implementation of selective-prevention services was recorded. Patient demographics, lifestyle-related cardiometabolic risk factors and opinions on the implementation’s feasibility were also collected. (3) Results: Acceptance rates varied from 19.5% (n = 39/200) in Sweden to 100% (n = 200/200) in the Czech Republic. Risk assessment completion rates ranged from 65.4% (n = 70/107) in Greece to 100% (n = 39/39) in Sweden. On a ten-point scale, the median (25–75% quartile) of participant-reported implementation feasibility ranged from 7.4 (6.9–7.8) in Greece to 9.2 (8.2–9.9) in Sweden. Willingness to change lifestyle exceeded 80% in all countries. (4) Conclusions: A substantial variation in the implementation of selective-prevention receptiveness and patient risk profile was observed among countries. Our findings suggest that the design and implementation of behavior change cardiometabolic programmes in each country should be informed by the local context and provide some background evidence towards this direction, which can be even more relevant during the current pandemic period.

Download Full-text

Implementation of healthy lifestyle promotion in primary care: Patients as coproducers

Patient Education and Counseling ◽

10.1016/j.pec.2014.07.033 ◽

2014 ◽

Vol 97 (2) ◽

pp. 283-290 ◽

Cited By ~ 4

Author(s):

Kristin Thomas ◽

Preben Bendtsen ◽

Barbro Krevers

Keyword(s):

Primary Care ◽

Healthy Lifestyle ◽

Healthy Lifestyle Promotion ◽

Primary Care Patients

Download Full-text

Implementation process of social prescribing to improve primary care patients’ health and well-being

European Journal of Public Health ◽

10.1093/eurpub/ckz186.457 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Dias ◽

C Figueiredo ◽

A Coelho ◽

L Hoffmeister ◽

A Gama

Keyword(s):

Primary Care ◽

Social Determinants Of Health ◽

Social Workers ◽

Social Determinants ◽

Implementation Process ◽

Skills Training ◽

Well Being ◽

Determinants Of Health ◽

Social Prescribing ◽

Primary Care Patients

Abstract Social prescribing (SP) is an innovative approach to tackle social determinants of health. It enables general practitioners (GPs) to address non-medical causes of ill-health by linking primary care patients with non-medical community sources of support. Despite convincing results from punctual evaluations, comprehensive evaluation of SP is needed to provide guidance on what works and evidence on its impact. A SP pilot-project started in 2018 in a primary care service in Lisbon. Its implementation process and outcomes are being evaluated through a longitudinal mixed-method evaluation study assessing patients’ wellbeing, quality of life, anxiety and depression in key stages of the intervention and stakeholders’ perspectives on facilitators/barriers to the intervention implementation. GPs refer patients to a social worker of the service, who defines with the patient the individual intervention plan using community resources. Initially, GPs and social workers were trained on SP, a network of community partners was built, SP information was distributed to patients, a referral online platform was created and a baseline study is being conducted. In the 1st semester, 130 patients were referred: 39.2% were ≥65 years old, 70.8% were female, 45.4% had foreign nationality. Over two thirds were referred for multiple reasons mostly social isolation, immigration/social integration, mental health, sedentary lifestyle, access to social benefits and employment/skills training. The project has enabling to support patients with multiple complex psychosocial needs. Regular meetings between GPs and partners have improving collaboration and patients’ supervision. The participatory approach and training emerged as facilitators of the intervention. Yet, the increased burden on social workers due to growing referral profile and some stakeholders’ scepticism toward SP need to be addressed. The triangulation of sources, methods and data provide evidence on the intervention impact and scalability. Key messages The social prescribing intervention has been effective in tackling multiple social determinants of health. Intervention evaluation is being key to identify facilitators and opportunities for scale up.

Download Full-text

Documentation of Student Pharmacists' Interventions from Medication Histories in a Primary Care Setting

Journal of Pharmacy Technology ◽

10.1177/875512250802400603 ◽

2008 ◽

Vol 24 (6) ◽

pp. 330-335 ◽

Cited By ~ 5

Author(s):

Kathy E Fit

Keyword(s):

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Vital Signs ◽

Pharmacy Practice ◽

Positive Outcomes ◽

Patient Demographics ◽

Faculty Supervision ◽

The Mean ◽

Acceptance Rates

Background: Medication safety is a major concern in primary care. Documented interventions by clinical pharmacists have shown positive clinical outcomes. In addition, it has been shown that student pharmacists have positive outcomes when participating in their advanced pharmacy practice experiences (APPEs). Most of this documentation has taken place in hospital settings. No data are available regarding interventions performed when APPE students record medication histories prior to a primary care provider (PCP) appointment. Objective: To describe the number and types of interventions made by APPE students in recording medication histories and to describe PCP acceptance rates. Methods: This prospective study documented the interventions from medication histories by 2 APPE students. With faculty supervision, the students recorded medication histories and vital signs prior to patient appointments with their PCPs. This was done approximately 1.5 days/week. Recommendations to the PCP were made verbally prior to the patient examination. Type of recommendation made, patient demographics, and PCP acceptance were documented. Descriptive statistics were employed. Results: Over 6 weeks, 109 interventions were documented. The mean ± SD patient age was 61.8 ± 14.94 years. The most common interventions documented were laboratory monitoring (22.0%), drug information (17.4%), and patient education (14.7%). Of the applicable interventions, 69% (49/71) were accepted by the PCP. Conclusions: APPE students in this clinic provided a variety of recommendations following completion of medication histories. A majority of the interventions were accepted. Such data demonstrate the benefit of including APPE students in patient care.

Download Full-text