1
|
Stol DM, Hollander M, Badenbroek IF, Nielen MMJ, Schellevis FG, de Wit NJ. Uptake and detection rate of a stepwise cardiometabolic disease detection program in primary care-a cohort study. Eur J Public Health 2020; 30:479-484. [PMID: 31722402 PMCID: PMC7292350 DOI: 10.1093/eurpub/ckz201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background Early detection and treatment of cardiometabolic diseases (CMD) in high-risk patients is a promising preventive strategy to anticipate the increasing burden of CMD. The Dutch guideline ‘the prevention consultation’ provides a framework for stepwise CMD risk assessment and detection in primary care. The aim of this study was to assess the outcome of this program in terms of newly diagnosed CMD. Methods A cohort study among 30 934 patients, aged 45–70 years without known CMD or CMD risk factors, who were invited for the CMD detection program within 37 general practices. Patients filled out a CMD risk score (step 1), were referred for additional risk profiling in case of high risk (step 2) and received lifestyle advice and (pharmacological) treatment if indicated (step 3). During 1-year follow-up newly diagnosed CMD, prescriptions and abnormal diagnostic tests were assessed. Results Twelve thousand seven hundred and thirty-eight patients filled out the risk score of which 865, 6665 and 5208 had a low, intermediate and high CMD risk, respectively. One thousand seven hundred and fifty-five high-risk patients consulted the general practitioner, in 346 of whom a new CMD was diagnosed. In an additional 422 patients a new prescription and/or abnormal diagnostic test were found. Conclusions Implementation of the CMD detection program resulted in a new CMD diagnosis in one-fifth of high-risk patients who attended the practice for completion of their risk profile. However, the potential yield of the program could be higher given the considerable number of additional risk factors—such as elevated glucose, blood pressure and cholesterol levels—found, requiring active follow-up and presumably treatment in the future.
Collapse
Affiliation(s)
- Daphne M Stol
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Correspondence: Daphne M. Stol, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands, Tel: +31 887568181, e-mail:
| | - Monika Hollander
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ilse F Badenbroek
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Mark M J Nielen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - François G Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (Location VUmc), Amsterdam, The Netherlands
| | - Niek J de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
2
|
Schutte T, Prince K, Richir M, Donker E, Gastel L, Bastiaans F, Vries H, Tichelaar J, Agtmael M. Opportunities for Students to Prescribe: An Evaluation of 185 Consultations in the Student‐run Cardiovascular Risk Management Programme. Basic Clin Pharmacol Toxicol 2017; 122:299-302. [DOI: 10.1111/bcpt.12904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 08/29/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Tim Schutte
- Department of Internal Medicine, Pharmacotherapy section VU University Medical Center Amsterdam the Netherlands
- RECIPE (Research & Expertise Center In Pharmacotherapy Education) Amsterdam the Netherlands
| | - Katinka Prince
- Department of General Practice & Elderly Care Medicine University General Practice Section VU University Medical Center Amsterdam the Netherlands
| | - Milan Richir
- Department of Internal Medicine, Pharmacotherapy section VU University Medical Center Amsterdam the Netherlands
- RECIPE (Research & Expertise Center In Pharmacotherapy Education) Amsterdam the Netherlands
| | - Erik Donker
- VU University Medical Center Amsterdam the Netherlands
| | - Leonie Gastel
- VU University Medical Center Amsterdam the Netherlands
| | - Ferdynand Bastiaans
- Department of General Practice & Elderly Care Medicine University General Practice Section VU University Medical Center Amsterdam the Netherlands
| | - Henk Vries
- Department of General Practice & Elderly Care Medicine University General Practice Section VU University Medical Center Amsterdam the Netherlands
- Department of General Practice & Elderly Care Medicine Student Education Section VU University Medical Center Amsterdam the Netherlands
| | - Jelle Tichelaar
- Department of Internal Medicine, Pharmacotherapy section VU University Medical Center Amsterdam the Netherlands
- RECIPE (Research & Expertise Center In Pharmacotherapy Education) Amsterdam the Netherlands
| | - Michiel Agtmael
- Department of Internal Medicine, Pharmacotherapy section VU University Medical Center Amsterdam the Netherlands
- RECIPE (Research & Expertise Center In Pharmacotherapy Education) Amsterdam the Netherlands
| |
Collapse
|
3
|
Bukman AJ, Teuscher D, Ben Meftah J, Groenenberg I, Crone MR, van Dijk S, Bos MB, Feskens EJM. Exploring strategies to reach individuals of Turkish and Moroccan origin for health checks and lifestyle advice: a mixed-methods study. BMC FAMILY PRACTICE 2016; 17:85. [PMID: 27439610 PMCID: PMC4955164 DOI: 10.1186/s12875-016-0476-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 07/06/2016] [Indexed: 11/10/2022]
Abstract
Background Low participation rates among ethnic minorities in preventive healthcare services are worrisome and not well understood. The objective of this study was to explore how adults of Turkish and Moroccan origin living in the Netherlands, aged 45 years and older, can be reached to participate in health checks for cardio-metabolic diseases and follow-up (lifestyle) advice. Methods This mixed-methods study used a convergent parallel design, to combine data of one quantitative study and three qualitative studies. Questionnaire data were included of 310 respondents, and interview data from 22 focus groups and four individual interviews. Participants were recruited via a research database, general practitioners and key figures. Quantitative data were analysed descriptively and qualitative data were analysed using a thematic approach. Results Regarding health checks, 50 % (95 % CI 41;59) of the Turkish questionnaire respondents and 66 % (95 % CI 57;76) of the Moroccan questionnaire respondents preferred an invitation from their general practitioner. The preferred location to fill out the health check questionnaire was for both ethnic groups the general practitioner’s office or at home, on paper. Regarding advice, both groups preferred to receive advice at individual level rather than in a group, via either a physician or a specialised healthcare professional. It was emphasised that the person who gives lifestyle advice should be familiar with the (eating) habits of the targeted individual. Sixty-one percent (95 % CI 53;69) of the Turkish respondents preferred to receive information in their native language compared to 37 % (95 % CI 29;45) of the Moroccan respondents. Several participants mentioned a low proficiency in the local language as an explanation for their preference to fill out the health check questionnaire at home, to receive advice from an ethnic-matched professional, and to receive information in their native language. Conclusions The general practitioner is considered as a promising contact to reach adults of Turkish and Moroccan origin for health checks or (lifestyle) advice. It might be necessary to provide information in individuals’ native language to overcome language barriers. In addition, (lifestyle) advice must be tailored. The obtained insight into preferences of Turkish and Moroccan adults regarding reach for preventive healthcare services could help professionals to successfully target these groups.
Collapse
Affiliation(s)
- Andrea J Bukman
- Division of Human Nutrition, Wageningen University, P.O Box 8129, 6700 EV, Wageningen, The Netherlands.
| | - Dorit Teuscher
- Department of Human Biology, Maastricht University Medical Centre+, NUTRIM School for Nutrition, Toxicology and Metabolism, P.O Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jamila Ben Meftah
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2300 RC, Leiden, The Netherlands
| | - Iris Groenenberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2300 RC, Leiden, The Netherlands
| | - Mathilde R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2300 RC, Leiden, The Netherlands
| | - Sandra van Dijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2300 RC, Leiden, The Netherlands.,Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioral Sciences, Leiden University, P.O Box 9555, 2300 RB, Leiden, The Netherlands
| | - Marieke B Bos
- Dutch Heart Foundation, P.O Box 300, 2501 CH, The Hague, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University, P.O Box 8129, 6700 EV, Wageningen, The Netherlands
| |
Collapse
|