View in EDS PDF Full Text

Barriers to prevention of cardiovascular disease in primary care settings in Argentina.

Saved in:
Bibliographic Details
Title: Barriers to prevention of cardiovascular disease in primary care settings in Argentina.
Alternate Title: Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina.
Authors: Ferrante, Daniel1 dferrante@msal.gov.ar, Konfino, Jonatan2, Linetzky, Bruno2, Tambussi, Ana2, Laspiur, Sebástian2
Source: Pan American Journal of Public Health / Revista Panamericana de Salud Pública. Apr2013, Vol. 33 Issue 4, p259-266. 8p.
Subjects: CARDIOVASCULAR disease prevention, MEDICAL screening, CONFIDENCE intervals, GROUNDED theory, INTERVIEWING, RESEARCH methodology, MEDICAL protocols, QUALITATIVE research, CROSS-sectional method, DATA analysis software, DESCRIPTIVE statistics
Geographic Terms: ARGENTINA
Abstract (English): Objective. To identify main barriers to preventing cardiovascular disease and implementing clinical practice guidelines in primary care, to pilot implementation of a tailored enactment of the adapted World Health Organization guidelines to prevent cardiovascular disease, and to assess the impact of the intervention in risk stratification. Methods. A qualitative study was done with decision makers, health professionals, and staff from five primary health care centers, who were interviewed to identify the main barriers. A tailored intervention to apply the guidelines was then designed and implemented. To assess the impact of the intervention on risk factor screening, a before-and-after analysis was performed through a records review of independent samples of patients aged 40 years or older attending each center. Results. The main barriers identified were lack of awareness of guidelines and lack of knowledge about preventing cardiovascular disease, communication problems within health teams, lack of motivation, and organizational problems. Before (n = 226) and after (n = 234) the intervention, screening of the main risk factors increased: blood pressure measurement from 44.3% to 72.6%, cholesterol measurement from 20.7% to 49.7%, smoking status assessment from 20.4% to 56.1%, diabetes status assessment from 25.5% to 93.6%, and previous vascular event status from 33.2% to 74.3%. Global risk stratification was not done at baseline, compared with 45.1% after the intervention. Conclusions. The main barriers identified were useful in designing a tailored intervention. Although no clinical outcomes were evaluated, this study shows that the implementation is feasible, with increased risk stratification as a first step at better patient management [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo. Determinar las principales barreras en la prevención de las enfermedades cardiovasculares y la aplicación de las directrices de práctica clínica en atención primaria, guiar la adecuada puesta en práctica de las directrices adaptadas de la Organización Mundial de la Salud para prevenir las enfermedades cardiovasculares, y evaluar la repercusión de la intervención en la estratificación del riesgo. Métodos. Se llevó a cabo un estudio cualitativo dirigido a los encargados de adoptar las decisiones, los profesionales de la salud y el personal de cinco centros de atención primaria de salud, que fueron entrevistados con objeto de determinar las principales barreras. Posteriormente se diseñó y ejecutó una intervención adaptada para aplicar las directrices. Con objeto de evaluar la repercusión de la intervención sobre el tamizaje de los factores de riesgo, se llevaron a cabo un análisis anterior y posterior a la intervención mediante un examen de los registros de muestras independientes de pacientes de 40 años o mayores que acudían a cada centro. Resultados. Las principales barreras detectadas fueron el desconocimiento de las directrices y la carencia de información sobre la prevención de las enfermedades cardiovasculares, los problemas de comunicación dentro de los equipos de salud, la falta de motivación y los problemas organizativos. Al comparar los datos previos a la intervención (n = 226) con los posteriores a esta (n = 234), se observó un incremento del tamizaje de los principales factores de riesgo: la medición de la presión arterial de 44,3 a 72,6%, la determinación del colesterol de 20,7 a 49,7%, la evaluación de la presencia de tabaquismo de 20,4 a 56,1%, la evaluación de la presencia de diabetes de 25,5 a 93,6% y la evaluación de la presencia de un episodio vascular anterior de 33,2 a 74,3%. Al inicio del estudio no se llevaba a cabo la estratificación del riesgo global, en comparación con el 45,1% de estratificación realizada posteriormente a la intervención. Conclusiones. La determinación de las principales barreras fue útil para el diseño de una intervención adaptada. Aunque no se evaluaron los resultados clínicos, este estudio revela que la ejecución es factible, y que la mayor estratificación del riesgo constituye un primer paso en la mejora de la atención de los pacientes [ABSTRACT FROM AUTHOR]
Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud Pública is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
FullText Links:
  – Type: pdflink
Text:
  Availability: 0
Header DbId: lth
DbLabel: MedicLatina
An: 88918437
AccessLevel: 6
PubType: Periodical
PubTypeId: serialPeriodical
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Barriers to prevention of cardiovascular disease in primary care settings in Argentina.
– Name: TitleAlt
  Label: Alternate Title
  Group: TiAlt
  Data: Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ferrante%2C+Daniel%22">Ferrante, Daniel</searchLink><relatesTo>1</relatesTo><i> dferrante@msal.gov.ar</i><br /><searchLink fieldCode="AR" term="%22Konfino%2C+Jonatan%22">Konfino, Jonatan</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Linetzky%2C+Bruno%22">Linetzky, Bruno</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Tambussi%2C+Ana%22">Tambussi, Ana</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Laspiur%2C+Sebástian%22">Laspiur, Sebástian</searchLink><relatesTo>2</relatesTo>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Pan+American+Journal+of+Public+Health+%2F+Revista+Panamericana+de+Salud+Pública%22">Pan American Journal of Public Health / Revista Panamericana de Salud Pública</searchLink>. Apr2013, Vol. 33 Issue 4, p259-266. 8p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22CARDIOVASCULAR+disease+prevention%22">CARDIOVASCULAR disease prevention</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+screening%22">MEDICAL screening</searchLink><br /><searchLink fieldCode="DE" term="%22CONFIDENCE+intervals%22">CONFIDENCE intervals</searchLink><br /><searchLink fieldCode="DE" term="%22GROUNDED+theory%22">GROUNDED theory</searchLink><br /><searchLink fieldCode="DE" term="%22INTERVIEWING%22">INTERVIEWING</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH+methodology%22">RESEARCH methodology</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+protocols%22">MEDICAL protocols</searchLink><br /><searchLink fieldCode="DE" term="%22QUALITATIVE+research%22">QUALITATIVE research</searchLink><br /><searchLink fieldCode="DE" term="%22CROSS-sectional+method%22">CROSS-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22DATA+analysis+software%22">DATA analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22DESCRIPTIVE+statistics%22">DESCRIPTIVE statistics</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22ARGENTINA%22">ARGENTINA</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objective. To identify main barriers to preventing cardiovascular disease and implementing clinical practice guidelines in primary care, to pilot implementation of a tailored enactment of the adapted World Health Organization guidelines to prevent cardiovascular disease, and to assess the impact of the intervention in risk stratification. Methods. A qualitative study was done with decision makers, health professionals, and staff from five primary health care centers, who were interviewed to identify the main barriers. A tailored intervention to apply the guidelines was then designed and implemented. To assess the impact of the intervention on risk factor screening, a before-and-after analysis was performed through a records review of independent samples of patients aged 40 years or older attending each center. Results. The main barriers identified were lack of awareness of guidelines and lack of knowledge about preventing cardiovascular disease, communication problems within health teams, lack of motivation, and organizational problems. Before (n = 226) and after (n = 234) the intervention, screening of the main risk factors increased: blood pressure measurement from 44.3% to 72.6%, cholesterol measurement from 20.7% to 49.7%, smoking status assessment from 20.4% to 56.1%, diabetes status assessment from 25.5% to 93.6%, and previous vascular event status from 33.2% to 74.3%. Global risk stratification was not done at baseline, compared with 45.1% after the intervention. Conclusions. The main barriers identified were useful in designing a tailored intervention. Although no clinical outcomes were evaluated, this study shows that the implementation is feasible, with increased risk stratification as a first step at better patient management [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivo. Determinar las principales barreras en la prevención de las enfermedades cardiovasculares y la aplicación de las directrices de práctica clínica en atención primaria, guiar la adecuada puesta en práctica de las directrices adaptadas de la Organización Mundial de la Salud para prevenir las enfermedades cardiovasculares, y evaluar la repercusión de la intervención en la estratificación del riesgo. Métodos. Se llevó a cabo un estudio cualitativo dirigido a los encargados de adoptar las decisiones, los profesionales de la salud y el personal de cinco centros de atención primaria de salud, que fueron entrevistados con objeto de determinar las principales barreras. Posteriormente se diseñó y ejecutó una intervención adaptada para aplicar las directrices. Con objeto de evaluar la repercusión de la intervención sobre el tamizaje de los factores de riesgo, se llevaron a cabo un análisis anterior y posterior a la intervención mediante un examen de los registros de muestras independientes de pacientes de 40 años o mayores que acudían a cada centro. Resultados. Las principales barreras detectadas fueron el desconocimiento de las directrices y la carencia de información sobre la prevención de las enfermedades cardiovasculares, los problemas de comunicación dentro de los equipos de salud, la falta de motivación y los problemas organizativos. Al comparar los datos previos a la intervención (n = 226) con los posteriores a esta (n = 234), se observó un incremento del tamizaje de los principales factores de riesgo: la medición de la presión arterial de 44,3 a 72,6%, la determinación del colesterol de 20,7 a 49,7%, la evaluación de la presencia de tabaquismo de 20,4 a 56,1%, la evaluación de la presencia de diabetes de 25,5 a 93,6% y la evaluación de la presencia de un episodio vascular anterior de 33,2 a 74,3%. Al inicio del estudio no se llevaba a cabo la estratificación del riesgo global, en comparación con el 45,1% de estratificación realizada posteriormente a la intervención. Conclusiones. La determinación de las principales barreras fue útil para el diseño de una intervención adaptada. Aunque no se evaluaron los resultados clínicos, este estudio revela que la ejecución es factible, y que la mayor estratificación del riesgo constituye un primer paso en la mejora de la atención de los pacientes [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud Pública is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lth&AN=88918437
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1590/S1020-49892013000400004
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 259
    Subjects:
      – SubjectFull: CARDIOVASCULAR disease prevention
        Type: general
      – SubjectFull: MEDICAL screening
        Type: general
      – SubjectFull: CONFIDENCE intervals
        Type: general
      – SubjectFull: GROUNDED theory
        Type: general
      – SubjectFull: INTERVIEWING
        Type: general
      – SubjectFull: RESEARCH methodology
        Type: general
      – SubjectFull: MEDICAL protocols
        Type: general
      – SubjectFull: QUALITATIVE research
        Type: general
      – SubjectFull: CROSS-sectional method
        Type: general
      – SubjectFull: DATA analysis software
        Type: general
      – SubjectFull: DESCRIPTIVE statistics
        Type: general
      – SubjectFull: ARGENTINA
        Type: general
    Titles:
      – TitleFull: Barriers to prevention of cardiovascular disease in primary care settings in Argentina.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ferrante, Daniel
      – PersonEntity:
          Name:
            NameFull: Konfino, Jonatan
      – PersonEntity:
          Name:
            NameFull: Linetzky, Bruno
      – PersonEntity:
          Name:
            NameFull: Tambussi, Ana
      – PersonEntity:
          Name:
            NameFull: Laspiur, Sebástian
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 04
              Text: Apr2013
              Type: published
              Y: 2013
          Identifiers:
            – Type: issn-print
              Value: 10204989
          Numbering:
            – Type: volume
              Value: 33
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Pan American Journal of Public Health / Revista Panamericana de Salud Pública
              Type: main
ResultId 1