Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina
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...
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Pan American Health Organization
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ftdoajarticles:oai:doaj.org/article:d46ecb1feb104fe186ad1f75bab6af70 2023-05-15T15:18:13+02:00 Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina Daniel Ferrante Jonatan Konfino Bruno Linetzky Ana Tambussi Sebástian Laspiur 2013-04-01T00:00:00Z https://doaj.org/article/d46ecb1feb104fe186ad1f75bab6af70 EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892013000400004 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/d46ecb1feb104fe186ad1f75bab6af70 Revista Panamericana de Salud Pública, Vol 33, Iss 4, Pp 259-266 (2013) Enfermedades cardiovasculares prevención primaria prevención de enfermedades Argentina Cardiovascular diseases primary prevention disease prevention Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles 2022-12-31T08:51:10Z 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. 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 ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Argentina |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Enfermedades cardiovasculares prevención primaria prevención de enfermedades Argentina Cardiovascular diseases primary prevention disease prevention Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Enfermedades cardiovasculares prevención primaria prevención de enfermedades Argentina Cardiovascular diseases primary prevention disease prevention Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Daniel Ferrante Jonatan Konfino Bruno Linetzky Ana Tambussi Sebástian Laspiur Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
topic_facet |
Enfermedades cardiovasculares prevención primaria prevención de enfermedades Argentina Cardiovascular diseases primary prevention disease prevention Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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. 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 ... |
format |
Article in Journal/Newspaper |
author |
Daniel Ferrante Jonatan Konfino Bruno Linetzky Ana Tambussi Sebástian Laspiur |
author_facet |
Daniel Ferrante Jonatan Konfino Bruno Linetzky Ana Tambussi Sebástian Laspiur |
author_sort |
Daniel Ferrante |
title |
Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
title_short |
Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
title_full |
Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
title_fullStr |
Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
title_full_unstemmed |
Barriers to prevention of cardiovascular disease in primary care settings in Argentina Obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en Argentina |
title_sort |
barriers to prevention of cardiovascular disease in primary care settings in argentina obstáculos en la prevención de las enfermedades cardiovasculares en entornos de atención primaria en argentina |
publisher |
Pan American Health Organization |
publishDate |
2013 |
url |
https://doaj.org/article/d46ecb1feb104fe186ad1f75bab6af70 |
geographic |
Arctic Argentina |
geographic_facet |
Arctic Argentina |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 33, Iss 4, Pp 259-266 (2013) |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892013000400004 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/d46ecb1feb104fe186ad1f75bab6af70 |
_version_ |
1766348442662076416 |