Abstract
BackgroundOwing to the rising disease burden of cardiometabolic diseases (CMD), prevention programmes for CMD are increasingly implemented in primary care. Organisational practice characteristics and availability of preventive services may be associated with a more effective programme.AimTo identify possible organisational success factors from general practices related to an effective primary prevention programme for CMD.Design & settingA prospective intervention study involving 37 Dutch general practices was undertaken.MethodPatients aged 45–70 years without known CMD, hypertension, or hypercholesterolemia were invited for the prevention programme. The outcome measures were an improvement (yes/no) in four different CMD risk factors between baseline and 1-year follow-up on an individual level (body mass index [BMI], smoking, systolic blood pressure, and cholesterol ratio). Multivariate logistic regression analysis was used for assessing associations between practice organisational characteristics and outcomes.ResultsJust over half of the participants showed an improvement on one or more risk factors. Marginal differences were found in the four different outcomes between the practices with different organisational characteristics. None of the practice characteristics that were tested showed a significant association with an improvement in one of the outcome measures.ConclusionIn this study, general practice organisational and preventive service characteristics showed no impact on the effectiveness of a CMD prevention programme. Possible explanations could be the effectiveness of protocolised pharmaceutical treatment and only limited contribution of lifestyle programmes on the improvement of CMD risk factors.
Highlights
During the past decades healthcare systems have been confronted with an increasing disease burden of cardiometabolic diseases (CMD), including cardiovascular disease, type 2 diabetes mellitus, and chronic kidney disease
In this study, general practice organisational and preventive service characteristics showed no impact on the effectiveness of a CMD prevention programme
Possible explanations could be the effectiveness of protocolised pharmaceutical treatment and only limited contribution of lifestyle programmes on the improvement of CMD risk factors
Summary
During the past decades healthcare systems have been confronted with an increasing disease burden of cardiometabolic diseases (CMD), including cardiovascular disease, type 2 diabetes mellitus, and chronic kidney disease. CMD are the number one cause of death globally and are accountable for more than half of all deaths across the World Health Organization European Region.[1] Worldwide, an estimated 17.9 million people die of cardiovascular disease each year, diabetes causes another 1.6 million deaths yearly, and approximately 1.2 million people die from kidney failure.[1] Lifestyle- related risk factors are accountable for 80% of all CMD.[2] This has caused a shift from a curative to a more preventive approach, with counselling for a healthy lifestyle as an indispensable factor. Organisational practice characteristics and availability of preventive services may be associated with a more effective programme
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