Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador
Objective. To assess the feasibility of implementing a physician-based, patient-centered counseling intervention model in Ecuador to improve the ability of primary care physicians (PCPs) to reduce cardiovascular disease (CVD) risk factors among patients. Methods. This was a randomized clinical trial...
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Online Access: | https://doi.org/10.26633/RPSP.2018.139 https://doaj.org/article/9e24a474463f40958cf57d56e1b3f49a |
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ftdoajarticles:oai:doaj.org/article:9e24a474463f40958cf57d56e1b3f49a 2023-05-15T15:15:37+02:00 Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador Manuel E. Baldeón Marco Fornasini Nancy Flores Philip A. Merriam Milagros Rosal Juan C. Zevallos Ira Ocken 2018-09-01T00:00:00Z https://doi.org/10.26633/RPSP.2018.139 https://doaj.org/article/9e24a474463f40958cf57d56e1b3f49a EN ES PT eng spa por Pan American Health Organization http://iris.paho.org/xmlui/handle/123456789/49468 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2018.139 https://doaj.org/article/9e24a474463f40958cf57d56e1b3f49a Revista Panamericana de Salud Pública, Vol 42, Pp 1-9 (2018) Cardiovascular diseases health human resource training diabetes mellitus type 2 cholesterol HDL LDL blood pressure Ecuador Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.26633/RPSP.2018.139 2022-12-31T03:22:41Z Objective. To assess the feasibility of implementing a physician-based, patient-centered counseling intervention model in Ecuador to improve the ability of primary care physicians (PCPs) to reduce cardiovascular disease (CVD) risk factors among patients. Methods. This was a randomized clinical trial conducted in primary care clinics in Quito in 2014 – 2016. Participants included 15 PCPs and their adult patients at high risk of developing type-2 diabetes. A physician-based and patient-centered counseling program was delivered to eight PCPs. Seven PCPs who did not receive the training comprised the control group. The patient experience was assessed by a patient exit interview (PEI). Assessment of the patient's anthropometrics, blood pressure, and blood biochemistry parameters were conducted. Changes within and between groups were estimated utilizing chi-square, ANOVA, paired t-tests, and coefficient with intervention. Results. A total of 197 patients participated, 113 in the intervention care group (ICG) and 84 in the usual care group (UCG); 99 patients (87.6%) in the ICG and 63 (75%) in the UCG completed the study. Counseling steps, measured by the PEI, were significantly higher in the ICG (8.9±1.6 versus 6.6±2.3; P = 0.001). Comparison of the estimated difference between the ICG and the UCG showed greater decreases in HbA1c and total cholesterol in the ICG. Within the ICG, there were significant improvements in weight, BMI, HbA1C, total cholesterol, and LDL-cholesterol. Conclusions. Training PCPs in a patient-centered behavioral intervention for CVD risk factor reduction is feasible and efficacious for reducing CVD risk factors in Ecuador. Developed and developing countries alike could benefit from such an intervention. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Quito ENVELOPE(-59.783,-59.783,-62.450,-62.450) Revista Panamericana de Salud Pública 42 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Cardiovascular diseases health human resource training diabetes mellitus type 2 cholesterol HDL LDL blood pressure Ecuador Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Cardiovascular diseases health human resource training diabetes mellitus type 2 cholesterol HDL LDL blood pressure Ecuador Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Manuel E. Baldeón Marco Fornasini Nancy Flores Philip A. Merriam Milagros Rosal Juan C. Zevallos Ira Ocken Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
topic_facet |
Cardiovascular diseases health human resource training diabetes mellitus type 2 cholesterol HDL LDL blood pressure Ecuador Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Objective. To assess the feasibility of implementing a physician-based, patient-centered counseling intervention model in Ecuador to improve the ability of primary care physicians (PCPs) to reduce cardiovascular disease (CVD) risk factors among patients. Methods. This was a randomized clinical trial conducted in primary care clinics in Quito in 2014 – 2016. Participants included 15 PCPs and their adult patients at high risk of developing type-2 diabetes. A physician-based and patient-centered counseling program was delivered to eight PCPs. Seven PCPs who did not receive the training comprised the control group. The patient experience was assessed by a patient exit interview (PEI). Assessment of the patient's anthropometrics, blood pressure, and blood biochemistry parameters were conducted. Changes within and between groups were estimated utilizing chi-square, ANOVA, paired t-tests, and coefficient with intervention. Results. A total of 197 patients participated, 113 in the intervention care group (ICG) and 84 in the usual care group (UCG); 99 patients (87.6%) in the ICG and 63 (75%) in the UCG completed the study. Counseling steps, measured by the PEI, were significantly higher in the ICG (8.9±1.6 versus 6.6±2.3; P = 0.001). Comparison of the estimated difference between the ICG and the UCG showed greater decreases in HbA1c and total cholesterol in the ICG. Within the ICG, there were significant improvements in weight, BMI, HbA1C, total cholesterol, and LDL-cholesterol. Conclusions. Training PCPs in a patient-centered behavioral intervention for CVD risk factor reduction is feasible and efficacious for reducing CVD risk factors in Ecuador. Developed and developing countries alike could benefit from such an intervention. |
format |
Article in Journal/Newspaper |
author |
Manuel E. Baldeón Marco Fornasini Nancy Flores Philip A. Merriam Milagros Rosal Juan C. Zevallos Ira Ocken |
author_facet |
Manuel E. Baldeón Marco Fornasini Nancy Flores Philip A. Merriam Milagros Rosal Juan C. Zevallos Ira Ocken |
author_sort |
Manuel E. Baldeón |
title |
Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
title_short |
Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
title_full |
Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
title_fullStr |
Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
title_full_unstemmed |
Impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in Ecuador |
title_sort |
impact of training primary care physicians in behavioral counseling to reduce cardiovascular disease risk factors in ecuador |
publisher |
Pan American Health Organization |
publishDate |
2018 |
url |
https://doi.org/10.26633/RPSP.2018.139 https://doaj.org/article/9e24a474463f40958cf57d56e1b3f49a |
long_lat |
ENVELOPE(-59.783,-59.783,-62.450,-62.450) |
geographic |
Arctic Quito |
geographic_facet |
Arctic Quito |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 42, Pp 1-9 (2018) |
op_relation |
http://iris.paho.org/xmlui/handle/123456789/49468 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2018.139 https://doaj.org/article/9e24a474463f40958cf57d56e1b3f49a |
op_doi |
https://doi.org/10.26633/RPSP.2018.139 |
container_title |
Revista Panamericana de Salud Pública |
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42 |
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