MEDICAL AND SOCIAL JUSTIFICATION OF MULTI-FACTOR PREVENTION OF MAJOR NONCOMMUNICABLE DISEASES

Abstract

Purpose – to substantiate and propose a model of multi-factor prevention of majornoncommunicable diseases (NCDs) at the level of primary health care (PHC).Material and methods. The analysis of the results of a cross-sectional sociologicalstudy (N=1252); copying from the medical documentation of inpatients (n=1543) andtheir survey data (n=57) were the materials and basis for the development of the model.Content analysis, conceptual modelling method, and statistical methods (PIVOT, χ2test,step-by-step logistic regression analysis) were used.Results. The prevalence of combined pathology of NCDs was determined on the exampleof hospitalized patients. The importance of taking into account the age and results ofthe primary screening in the formation of the COPD risk group and the possibility ofsupplementing it with an assessment of the risk of fatal complications of cardiovasculardiseases on the SCORE scale is proved. Features of prevalence and combination ofrisk factors (RF) and the major NCDs among the economically active population arerevealed. It was found that with the same targeted preventive consultation of patients byPHC and specialized medical care doctors, the effectiveness of interventions significantlyincreases. The key to the high effectiveness of prevention is proved to be coordinatedcooperation between medical professionals at different levels of medical care and patientand their families.Conclusions. The proposed model of multi-factor prevention of major NCDs is based ona patient-oriented approach, taking into account the combined RF and major NCDs. Theprinciple of an integrated approach and the complexity of interventions is ensured bylayering all types of prevention provided by PHC in cooperation with specialized medicalcare and the public health service.