scholarly journals Technology-Assisted Collaborative Care Program for People with Diabetes and/or High Blood Pressure Attending Primary Health Care: A Feasibility Study

2021 ◽  
Vol 18 (22) ◽  
pp. 12000
Author(s):  
Pablo Martínez ◽  
Viviana Guajardo ◽  
Víctor E. Gómez ◽  
Sebastián Brandt ◽  
Wilsa Szabo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
Depressive Symptoms ◽  
High Blood Pressure ◽  
Collaborative Care ◽  
Care Program ◽  
Computer Assisted ◽  
Primary Health ◽  
Health Related

The comorbidity of depression with physical chronic diseases is usually not considered in clinical guidelines. This study evaluated the feasibility of a technology-assisted collaborative care (TCC) program for depression in people with diabetes and/or high blood pressure (DM/HBP) attending a primary health care (PHC) facility in Santiago, Chile. Twenty people diagnosed with DM/HBP having a Patient Health Questionnaire-9 score ≥ 15 points were recruited. The TCC program consisted of a face-to-face, computer-assisted psychosocial intervention (CPI, five biweekly sessions), telephone monitoring (TM), and a mobile phone application for behavioral activation (CONEMO). Assessments of depressive symptoms and other health-related outcomes were made. Thirteen patients completed the CAPI, 12 received TM, and none tried CONEMO. The TCC program was potentially efficacious in treating depression, with two-thirds of participants achieving response to depression treatment 12 weeks after baseline. Decreases were observed in depressive symptoms and healthcare visits and increases in mental health-related quality of life and adherence to treatment. Patients perceived the CPI as acceptable. The TCC program was partially feasible and potentially efficacious for managing depression in people with DM/HBP. These data are valuable inputs for a future randomized clinical trial.

scholarly journals Prevalence of risk factors for dementia in middle- and older- aged people registered in Primary Health Care

2021 ◽  
Vol 15 (2) ◽  
pp. 239-247
Author(s):  
Bruna Moretti Luchesi ◽  
Beatriz Rodrigues de Souza Melo ◽  
Priscila Balderrama ◽  
Aline Cristina Martins Gratão ◽  
Marcos Hortes Nisihara Chagas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
Depressive Symptoms ◽  
Visual Impairment ◽  
High Blood Pressure ◽  
Physical Inactivity ◽  
Age Group ◽  
Primary Health

ABSTRACT. It is important to assess the prevalence of risk factors for dementia to slow down the progression and evolution of the disease, and to support interventions and prevention programs. Objective: We aimed to evaluate the prevalence of these factors in individuals registered in Primary Health Care in Brazil and their relationship with sex and age group. Methods: This was a cross-sectional and quantitative study with n=300 individuals. We evaluated the prevalence of main risk factors (low education, hearing loss, high blood pressure, obesity, smoking, depression, physical inactivity, social isolation, and diabetes mellitus) and others (poor diet, alcohol use, head trauma, monolingualism, visual impairment, and sleep disorders) identified in the literature. Poisson regression was used, according to sex and age group (45-59 years/60+ years). Results: The main risk factors with the highest prevalence were physical inactivity (60.3%) and depressive symptoms and hypertension (56.7% each). Among the other factors, monolingualism (98.0%), visual impairment (84.7%), and irregular consumption of fruits (60.4%), and vegetables (53.5%) prevailed. No differences were identified between sexes. The regression analysis confirmed a significant difference for education and age group, with older individuals having a higher prevalence of low schooling. Conclusion: The results can guide interventions, especially in developing countries. Practice of physical activity and healthy eating should be the focus of these interventions as they can indirectly help in reducing the prevalence of other factors. Early identification, screening and adequate treatment of depressive symptoms, high blood pressure and visual impairment can also contribute to reducing the prevalence of dementia.

scholarly journals Levels of Adherence of an Exercise Referral Scheme in Primary Health Care: Effects on Clinical and Anthropometric Variables and Depressive Symptoms of Hypertensive Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Katia Gallegos-Carrillo ◽  
Carmen Garcia-Peña ◽  
Nelly Salgado-de-Snyder ◽  
Jorge Salmerón ◽  
Felipe Lobelo
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Depressive Symptoms ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Related Quality ◽  
Health Related ◽  
Exercise Referral

Among the modifiable health behaviors, physical activity (PA) promotion has been one of the challenges in primary care, particularly how to translate the results of proven interventions and implement them in the real world. This study was aimed to compare whether two programs designed for hypertensive patients achieve changes in clinical and anthropometric variables, quality of life, and depressive symptoms; and if higher levels of adherence to one of the interventions using an exercise referral (ER) approach achieved better health outcomes. Pragmatic cluster randomized trials were carried out in four Primary Health Care Units (PHCUs). Physicians in the PHCUs identified hypertensive patients and assessed whether they were eligible to be part of this trial. Each center was randomized to a brief PA counseling (BC, n = 2) or an exercise referral (ER, n = 2) intervention to conducted PA programs among hypertensive patients aged 35–70 years, self-reported as physically inactive. Outcome variables included changes in blood pressure levels, triglycerides, HDL cholesterol, fasting glucose, body mass index, waist/hip ratio, abdominal obesity, and metabolic syndrome risk score, health-related quality of life, and depressive symptoms. Longitudinal multilevel analyses assessed the effects of the BC and ER programs and the level of adherence of the ER on clinical, anthropometric, and mental health variables, models were linear for continuous variables, and logistic for dichotomous variables. Differences were observed in triglycerides, BMI, metabolic risk scores variables, and depressive symptoms among ER and BC programs. In addition, differences in the ER group were observed according to the level of adherence in blood pressure levels, waist circumference and waist/hip ratio, depressive symptoms, and the mental health component of health-related quality of life. An ER program in comparison to a BC intervention is promoting changes in some specific health indicators of hypertensive patients, showing the usefulness of these PA programs in primary health care facilities.

scholarly journals Potential Impact of the New American High Blood Pressure Guidelines on Hypertension Prevalence in a Primary Health Care Unit in Rio de Janeiro – the LapARC Study

2021 ◽  
Author(s):  
Marcelle Guimarães de Oliveira ◽  
Angélica Furriel de Almeida da Silva ◽  
Taissa Lorena dos Santos ◽  
Mariana Loureiro Cunha ◽  
Bruna Rosenbrock Ferreira Taveira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Primary Health Care ◽  
High Blood Pressure ◽  
Rio De Janeiro ◽  
Hypertension Prevalence ◽  
Primary Health ◽  
Health Care Unit ◽  
Potential Impact

scholarly journals Barriers, Facilitators, and Proposals for Improvement in the Implementation of a Collaborative Care Program for Depression: A Qualitative Study of Primary Care Doctor and Nurse Experiences

2021 ◽  
Author(s):  
Enric Aragonès ◽  
Germán López-Cortacans ◽  
Narcís Cardoner ◽  
Catarina Tomé-Pires ◽  
Daniel Porta-Casteràs ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Collaborative Care ◽  
Health Care Professionals ◽  
Care Program ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. Methods: One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. Results: The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation.Conclusions: The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation.Trial registration: ClinicalTrials.gov identifier: NCT03285659; Registered 18th September, 2017.

Evaluation of a primary health care program for the poor

1989 ◽  
Vol 14 (2) ◽  
pp. 107-120 ◽  
Author(s):  
Charles E. Begley ◽  
Lu Ann Aday ◽  
Roy McCandless
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Program ◽  
The Poor ◽  
Health Care Program ◽  
Primary Health

scholarly journals Measuring the performance of interprofessional primary health care teams: understanding the teams perspective

2019 ◽  
Vol 20 ◽  
Author(s):  
Catherine Donnelly ◽  
Rachelle Ashcroft ◽  
Amanda Mofina ◽  
Nicole Bobbette ◽  
Carol Mulder
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Performance Measurement ◽  
Collaborative Care ◽  
Performance Indicators ◽  
Interprofessional Collaboration ◽  
Health Care Teams ◽  
Primary Health ◽  
Care Models

Abstract Aim: The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers. Background: Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of interprofessional primary care models. Methods: A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question. Findings: A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of interprofessional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).

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