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Pandey AR, Dhimal M, Shrestha N, Sharma D, Maskey J, Dhungana RR, Bista B, Aryal KK. Burden of Cardiovascular Diseases in Nepal from 1990 to 2019: The Global Burden of Disease Study, 2019. Glob Health Epidemiol Genom 2023; 2023:3700094. [PMID: 37377984 PMCID: PMC10292936 DOI: 10.1155/2023/3700094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiovascular diseases (CVDs) have emerged as the leading cause of deaths worldwide in 2019. Globally, more than three-quarters of the total deaths due to CVDs occur in low- and middle-income countries like Nepal. Although increasing number of studies is available on the prevalence of CVDs, there is limited evidence presenting a complete picture on the burden of CVDs in Nepal. In this context, this study aims to provide comprehensive picture on the burden of CVDs in the country. This study is based on the Global Burden of Disease (GBD) study 2019, which is a multinational collaborative research covering 204 countries and territories across the world. The estimations made from the study are publicly available in the GBD Compare webpage operated by the Institute for Health Metrics and Evaluation (IHME), University of Washington. This article makes use of those data available on the GBD Compare page of IHME website to present the comprehensive picture of the burden of CVDs in Nepal. Overall, in 2019, there were an estimated 1,214,607 cases, 46,501 deaths, and 1,104,474 disability-adjusted life years (DALYs) due to CVDs in Nepal. The age-standardized mortality rates for CVDs witnessed a marginal reduction from 267.60 per 100,000 population in 1990 to 245.38 per 100,000 population in 2019. The proportion of deaths and DALYs attributable to CVDs increased from 9.77% to 24.04% and from 4.82% to 11.89%, respectively, between 1990 and 2019. Even though there are relatively stable rates of age-standardized prevalence, and mortality, the proportion of deaths and DALYs attributed to CVDs have risen sharply between 1990 and 2019. Besides implementing the preventive measures, the health system also needs to prepare itself for the delivery of long-term care of patients with CVDs which could have significant implications on resources and operations.
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Affiliation(s)
| | | | | | | | - Jasmine Maskey
- Oxford University Clinical Research Unit, Lalitpur, Nepal
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Journath G, Hammar N, Vikström M, Linnersjö A, Walldius G, Krakau I, Lindgren P, de Faire U, Hellenius ML. A Swedish primary healthcare prevention programme focusing on promotion of physical activity and a healthy lifestyle reduced cardiovascular events and mortality: 22-year follow-up of 5761 study participants and a reference group. Br J Sports Med 2020; 54:1294-1299. [PMID: 32680841 PMCID: PMC7588408 DOI: 10.1136/bjsports-2019-101749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2020] [Indexed: 11/04/2022]
Abstract
Objective To evaluate long-term risk of first cardiovascular (CV) events, CV deaths and all-cause deaths in community-dwelling participants of a cardiovascular disease (CVD) prevention programme delivered in a primary care setting. Methods Individuals who visited a primary healthcare service in Sollentuna (Sweden) and agreed to participate in the programme between 1988 and 1993 were followed. They had at least one CV risk factor but no prior myocardial infarction and received support to increase physical activity using the programme Physical Activity on Prescription and to adopt health-promoting behaviours including cooking classes, weight reduction, smoking cessation and stress management. Participants (n=5761) were compared with a randomly selected, propensity score-matched reference group from the general population in Stockholm County (n=34 556). All individuals were followed in Swedish registers until December 2011. Results In the intervention group and the reference group there were 698 (12.1%) and 4647 (13.4%) first CV events, 308 (5.3%) and 2261 (6.5%) CV deaths, and 919 (16.5%) and 6405 (18.5%) all-cause deaths, respectively, during a mean follow-up of 22 years. The HR (95% CI) in the intervention group compared with the reference group was 0.88 (0.81 to 0.95) for first CV events, 0.79 (0.70 to 0.89) for CV deaths and 0.83 (0.78 to 0.89) for all-cause deaths. Conclusions Participation in a CVD prevention programme in primary healthcare focusing on promotion of physical activity and healthy lifestyle was associated with lower risk of CV events (12%), CV deaths (21%) and all-cause deaths (17%) after two decades. Promoting physical activity and healthy living in the primary healthcare setting may prevent CVD.
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Affiliation(s)
- Gunilla Journath
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Max Vikström
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anette Linnersjö
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Göran Walldius
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingvar Krakau
- Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Peter Lindgren
- Medical Management Center, Department of Learning, Information, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,The Swedish Institute for Health Economics, Stockholm, Sweden
| | - Ulf de Faire
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mai-Lis Hellenius
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Khunti K, Gillies CL, Dallosso H, Brady EM, Gray LJ, Kilgallen G, Willis A, Zafar A, Davies MJ. Assessment of response rates and yields for Two opportunistic Tools for Early detection of Non-diabetic hyperglycaemia and Diabetes (ATTEND). A randomised controlled trial and cost-effectiveness analysis. Diabetes Res Clin Pract 2016; 118:12-20. [PMID: 27485852 DOI: 10.1016/j.diabres.2016.04.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/28/2016] [Accepted: 04/30/2016] [Indexed: 01/09/2023]
Abstract
AIMS To assess the opportunistic use in primary care of a computer risk score versus a self-assessment risk score for undiagnosed type 2 diabetes. METHODS We conducted a randomised controlled trial in 11 primary care practices in the UK. 577 patients aged 40-75years with no current diagnosis of type 2 diabetes were recruited to a computer based risk score (Leicester Practice Computer Risk Score (LPCRS)) or a patient self-assessment score (Leicester Self-Assessment Score (LSAS)). RESULTS The rate of self-referral blood tests was significantly higher for the LPCRS compared to the LSAS, 118.98 (95% CI: 102.85, 137.64) per 1000 high-risk patient years of follow-up compared to 92.14 (95% CI: 78.25, 108.49), p=0.022. Combined rate of diagnosis of type 2 diabetes and those at risk of developing the disease (i.e. impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)) was similar between the two arms, 15.12 (95% CI: 9.11, 25.08) per 1000 high-risk patient years for LPCRS compared to 14.72 (95% CI: 9.59, 22.57) for the LSAS, p=0.699. For the base case scenario the cost per new case of type 2 diabetes diagnosed was lower for the LPCRS compared to the LSAS, £168 (95% Credible Interval (CrI): 76, 364), and £352 (95% CrI: 109, 1148), respectively. CONCLUSIONS Compared to a self-assessment risk score, a computer based risk score resulted in greater attendance to an initial blood test and is potentially more cost-effective.
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Affiliation(s)
- K Khunti
- Leicester Diabetes Centre, University of Leicester, Leicester, UK.
| | - C L Gillies
- Leicester Diabetes Centre, University of Leicester, Leicester, UK; Department of Health Sciences, University of Leicester, Leicester, UK
| | - H Dallosso
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - E M Brady
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - L J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - G Kilgallen
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - A Willis
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - A Zafar
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - M J Davies
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
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Journath G, Hammar N, Elofsson S, Linnersjö A, Vikström M, Walldius G, Krakau I, Lindgren P, de Faire U, Hellénius ML. Time Trends in Incidence and Mortality of Acute Myocardial Infarction, and All-Cause Mortality following a Cardiovascular Prevention Program in Sweden. PLoS One 2015; 10:e0140201. [PMID: 26580968 PMCID: PMC4651336 DOI: 10.1371/journal.pone.0140201] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 09/22/2015] [Indexed: 11/18/2022] Open
Abstract
Background In 1988, a cardiovascular prevention program which combined an individual and a population-based strategy was launched within primary health-care in Sollentuna, a municipality in Stockholm County. The aim of this study was to investigate time trends in the incidence of and mortality from acute myocardial infarction and all-cause mortality in Sollentuna compared with the rest of Stockholm County during a period of two decades following the implementation of a cardiovascular prevention program. Materials and Methods The average population in Sollentuna was 56,589 (49% men) and in Stockholm County (Sollentuna included) 1,795,504 (49% men) during the study period of 1987–2010. Cases of hospitalized acute myocardial infarction and death were obtained for the population of Sollentuna and the rest of Stockholm County using national registries of hospital discharges and deaths. Acute myocardial infarction incidence and mortality were estimated using the average population of Sollentuna and Stockholm in 1987–2010. Results During the observation period, the incidence of acute myocardial infarction decreased more in Sollentuna compared with the rest of Stockholm County in women (-22% vs. -7%; for difference in slope <0.05). There was a trend towards a greater decline in Sollentuna compared to the rest of Stockholm County in the incidence of acute myocardial infarction (in men), acute myocardial mortality, and all-cause mortality but the differences were not significant. Conclusion During a period of steep decline in acute myocardial infarction incidence and mortality in Stockholm County the municipality of Sollentuna showed a stronger trend in women possibly compatible with favorable influence of a cardiovascular prevention program. Trial Registration ClinicalTrials.gov NCT02212145
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Affiliation(s)
- Gunilla Journath
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Hammar
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,AstraZeneca R&D, Mölndal, Sweden
| | - Stig Elofsson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Anette Linnersjö
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.,Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Max Vikström
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Walldius
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingvar Krakau
- Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Peter Lindgren
- Medical Management Center, MMC, Department of Learning, Information, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,The Swedish Institute for Health Economics, Stockholm, Sweden
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mai-Lis Hellénius
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Holland C, Cooper Y, Shaw R, Pattison H, Cooke R. Effectiveness and uptake of screening programmes for coronary heart disease and diabetes: a realist review of design components used in interventions. BMJ Open 2013; 3:e003428. [PMID: 24202056 PMCID: PMC3822301 DOI: 10.1136/bmjopen-2013-003428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/27/2013] [Accepted: 10/11/2013] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To evaluate behavioural components and strategies associated with increased uptake and effectiveness of screening for coronary heart disease and diabetes with an implementation science focus. DESIGN Realist review. DATA SOURCES PubMed, Web of Knowledge, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register and reference chaining. Searches limited to English language studies published since 1990. ELIGIBILITY CRITERIA Eligible studies evaluated interventions designed to increase the uptake of cardiovascular disease (CVD) and diabetes screening and examined behavioural and/or strategic designs. Studies were excluded if they evaluated changes in risk factors or cost-effectiveness only. RESULTS In 12 eligible studies, several different intervention designs and evidence-based strategies were evaluated. Salient themes were effects of feedback on behaviour change or benefits of health dialogues over simple feedback. Studies provide mixed evidence about the benefits of these intervention constituents, which are suggested to be situation and design specific, broadly supporting their use, but highlighting concerns about the fidelity of intervention delivery, raising implementation science issues. Three studies examined the effects of informed choice or loss versus gain frame invitations, finding no effect on screening uptake but highlighting opportunistic screening as being more successful for recruiting higher CVD and diabetes risk patients than an invitation letter, with no differences in outcomes once recruited. Two studies examined differences between attenders and non-attenders, finding higher risk factors among non-attenders and higher diagnosed CVD and diabetes among those who later dropped out of longitudinal studies. CONCLUSIONS If the risk and prevalence of these diseases are to be reduced, interventions must take into account what we know about effective health behaviour change mechanisms, monitor delivery by trained professionals and examine the possibility of tailoring programmes according to contexts such as risk level to reach those most in need. Further research is needed to determine the best strategies for lifelong approaches to screening.
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Affiliation(s)
- Carol Holland
- Health and Lifespan Psychology Group, School of Life & Health Sciences, Aston University, Birmingham, UK
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Krogsbøll LT, Jørgensen KJ, Grønhøj Larsen C, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev 2012; 10:CD009009. [PMID: 23076952 DOI: 10.1002/14651858.cd009009.pub2] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND General health checks are common elements of health care in some countries. These aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used screening tests offered in general health checks have been incompletely studied. Also, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is, therefore, important to assess whether general health checks do more good than harm. OBJECTIVES We aimed to quantify the benefits and harms of general health checks with an emphasis on patient-relevant outcomes such as morbidity and mortality rather than on surrogate outcomes such as blood pressure and serum cholesterol levels. SEARCH METHODS We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, MEDLINE, EMBASE, Healthstar, CINAHL, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) to July 2012. Two authors screened titles and abstracts, assessed papers for eligibility and read reference lists. One author used citation tracking (Web of Knowledge) and asked trialists about additional studies. SELECTION CRITERIA We included randomised trials comparing health checks with no health checks in adults unselected for disease or risk factors. We did not include geriatric trials. We defined health checks as screening general populations for more than one disease or risk factor in more than one organ system. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed the risk of bias in the trials. We contacted authors for additional outcomes or trial details when necessary. For mortality outcomes we analysed the results with random-effects model meta-analysis, and for other outcomes we did a qualitative synthesis as meta-analysis was not feasible. MAIN RESULTS We included 16 trials, 14 of which had available outcome data (182,880 participants). Nine trials provided data on total mortality (155,899 participants, 11,940 deaths), median follow-up time nine years, giving a risk ratio of 0.99 (95% confidence interval (CI) 0.95 to 1.03). Eight trials provided data on cardiovascular mortality (152,435 participants, 4567 deaths), risk ratio 1.03 (95% CI 0.91 to 1.17) and eight trials on cancer mortality (139,290 participants, 3663 deaths), risk ratio 1.01 (95% CI 0.92 to 1.12). Subgroup and sensitivity analyses did not alter these findings.We did not find an effect on clinical events or other measures of morbidity but one trial found an increased occurrence of hypertension and hypercholesterolaemia with screening and one trial found an increased occurence of self-reported chronic disease. One trial found a 20% increase in the total number of new diagnoses per participant over six years compared to the control group. No trials compared the total number of prescriptions, but two out of four trials found an increased number of people using antihypertensive drugs. Two out of four trials found small beneficial effects on self-reported health, but this could be due to reporting bias as the trials were not blinded. We did not find an effect on admission to hospital, disability, worry, additional visits to the physician, or absence from work, but most of these outcomes were poorly studied. We did not find useful results on the number of referrals to specialists, the number of follow-up tests after positive screening results, or the amount of surgery. AUTHORS' CONCLUSIONS General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased. Important harmful outcomes, such as the number of follow-up diagnostic procedures or short term psychological effects, were often not studied or reported and many trials had methodological problems. With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial.
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Petersson U, Ostgren CJ, Brudin L, Ovhed I, Nilsson PM. Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden. Scand J Public Health 2008; 36:389-96. [PMID: 18539693 DOI: 10.1177/1403494808089561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS It is well established that the main cause of the development of cardiovascular disease can be found in unhealthy lifestyle habits. In our study, we wanted to explore the long-term predictors of self-reported lifestyle changes in a middle-aged population after screening for cardiovascular risk factors 10 years earlier. METHODS We conducted a 10-year follow-up telephone interview on self-reported lifestyle changes in a rural population in south-eastern Sweden, after a cardiovascular screening programme. The population comprised 90% of all inhabitants (n=705) aged 40-59 years at baseline, and 90% of these (n=629) were reached for the telephone interview. RESULTS When multivariate logistic regression was used, a higher success rate for lifestyle changes was independently associated with female gender (odds ratio (OR)=1.56, 95% confidence interval (CI) 1.11-2.18). When stratified for gender, significant predictors for success in men were prevalent cardiovascular risk conditions (OR=4.77, 95% CI 2.18-10.5; p<0.001) and previous myocardial infarction (OR=22.8, 95% CI 4.73-110; p<0.001) at baseline. For women, elevated blood pressure (> or = 160 and/or > or = 90 mmHg) measured at baseline (OR=1.84, 95% CI 1.12-3.02; p=0.016) was significantly associated with successful lifestyle changes. Smoking at baseline was also associated with significant success: OR=3.36 (95% CI:2.05-5.51; p<0.001) and OR=1.81 (95% CI 1.11-2.95; p=0.017) for men and women, respectively. CONCLUSIONS Female gender was associated with significant improvements in self-reported lifestyle changes. Furthermore, smoking, a medical history of diabetes, hypertension, angina pectoris or myocardial infarction at baseline predicted success in lifestyle change in this 10-year follow-up study.
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Affiliation(s)
- Ulla Petersson
- Primary Health Care Centre, Söderåkra, Kalmar County Council, Kalmar, Sweden.
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Färnkvist L, Olofsson N, Weinehall L. Did a health dialogue matter? Self-reported cardiovascular disease and diabetes 11 years after health screening. Scand J Prim Health Care 2008; 26:135-9. [PMID: 18609252 PMCID: PMC3409600 DOI: 10.1080/02813430802113029] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To study the potential impact of health screening, with or without a motivational health dialogue, on the risk and morbidity of cardiovascular diseases (CVD) and diabetes (DM). DESIGN Two cross-sectional studies with an interval of 11 years. SETTING The community of Härnösand, Sweden. SUBJECTS In the first study, 402 men born in 1934, 1944, or 1954 underwent health screening for CVD prevention in 1989. In the second study, 415 men (of the same ages) completed a questionnaire in 2000 (11 years later). MAIN OUTCOME MEASURES Odds ratio (OR) for self-reported CVD and DM. RESULTS The odds ratio of self-reported CVD and DM was more than doubled among participants in the health screening without a health dialogue (OR 2.5; 95% CI 0.8-7.4) and threefold for those not participating (OR 3.0; 95% CI 1.0-8.8) compared with those who reported participation in health screening that included a structured health dialogue. CONCLUSIONS Health screening for the prevention of CVD and DM benefits from inclusion of a structured, motivational health dialogue.
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Affiliation(s)
- Lisbeth Färnkvist
- Department of Public Health and Research, Härnösand-Medelpad Medical Service, Sundsvall, Sweden.
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Kallings LV, Leijon M, Hellénius ML, Ståhle A. Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life. Scand J Med Sci Sports 2007; 18:154-61. [PMID: 17555539 DOI: 10.1111/j.1600-0838.2007.00678.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To examine whether physical activity on prescription in routine primary care patients would influence physical activity level and quality of life 6 months later. In 2001-2003, 13 Swedish primary health care units took part in an uncontrolled clinical study. If a patient in primary health care needed physical activity preventively or for treatment of a disease and patient-centered motivational counseling found physical activity to be suitable, individualized physical activity could be prescribed. Patients (n=481) of both sexes and all ages [75% women, mean age 50 (12-81)] participated in the study. Self-reported physical activity, readiness to change to a more physically active lifestyle and quality-of-life data were collected through questionnaires. The follow-up rate was 62% at 6 months. Intention-to-treat analysis showed a significant increase (P<0.01) in self-reported physical activity level, the stages of action and maintenance of physical activity as well as quality of life. Physical activity level, stages of change and quality of life increased analogically, indicating that physical activity on prescription may be suitable as a conventional treatment in an ordinary primary health care setting to promote a more physically active lifestyle.
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Affiliation(s)
- L V Kallings
- Department of Neurobiology, Health Care Sciences and Society/Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
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Miller SL, Reber RJ, Chapman-Novakofski K. Prevalence of CVD risk factors and impact of a two-year education program for premenopausal women. Womens Health Issues 2001; 11:486-93. [PMID: 11704469 DOI: 10.1016/s1049-3867(01)00127-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Indicators of cardiovascular disease risk in premenopausal women before, during, and after a 2-year educational intervention measured prevalence of risk and program effectiveness. Women (n = 277) were assigned to either treatment/education (n = 174) or control (n = 103) group. Many had at least one cardiovascular disease risk factor: high BMI (n = 123); high-fat diet (n = 160); and/or high body fat percent (n = 136). The treatment group was significant for change in calories from fat (P <.01). This study shows that premenopausal women have cardiovascular disease risks that should be addressed, and that nutrition education can successfully change dietary behavior.
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Affiliation(s)
- S L Miller
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, Illinois, USA
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