Senior onderzoeker Internationaal vergelijkend onderzoek (WHO)
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Effective interventions for the prevention and management of diabetes mellitus and cardiovascular diseases in primary care: a systematic review.
Snoeijs, S.P., Boerma, W.G.W., Baltag, V., Schellevis, F.G. Effective interventions for the prevention and management of diabetes mellitus and cardiovascular diseases in primary care: a systematic review. European Journal of Public Health: 2012, 22(suppl. 2), p. 217-218. Abstract. 5th European Public Health Conference 'All inclusive public health'. 7-10 November 2012, St. Julians (Malta).
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Background: Organising effective responses to the growing problem of noncommunicable diseases (NCD) is among the biggest challenges of (primary) health care systems. In particular tackling, cardiovascular diseases (CVDs) and diabetes mellitus type 2 (DM2) requires coordinated approaches close to where people are living. CVDs and DM2 are linked by common risk factors, underlying determinants and opportunities for interventions. This paper aims to provide the evidence for effective prevention and interventions in primary care related to these NCDs. Methods: In Medline, 65 systematic reviews, meta-analyses, cohort studies and randomized controlled trials (RCTs) have been included, systematically reviewed and independently screened by three researchers. Disagreements were discussed until consensus was reached. The Chronic Care Model (CCM) was used to structure the characteristics of the interventions that were identified in the papers. Results: Results show that, in general, prevention and management of CVDs and DM2 in primary care is most likely to be successful when interventions are multifactorial and are provided in a coordinated way by different primary care workers. Furthermore, conditions should be created that enable professionals to incorporate the interventions in their practice routine. It will be a challenge to integrate a heterogeneous mix of activities into a comprehensive chronic care package that includes a major role of selfactivated ('pre’-)patients. Effective interventions and strategies for the prevention and management of CVD and DM2 in primary care will be presented. Features of health care systems will also be taken into account, in particular which options are feasible for countries with a lower level of resources. (aut. ref.)
Background: Organising effective responses to the growing problem of noncommunicable diseases (NCD) is among the biggest challenges of (primary) health care systems. In particular tackling, cardiovascular diseases (CVDs) and diabetes mellitus type 2 (DM2) requires coordinated approaches close to where people are living. CVDs and DM2 are linked by common risk factors, underlying determinants and opportunities for interventions. This paper aims to provide the evidence for effective prevention and interventions in primary care related to these NCDs. Methods: In Medline, 65 systematic reviews, meta-analyses, cohort studies and randomized controlled trials (RCTs) have been included, systematically reviewed and independently screened by three researchers. Disagreements were discussed until consensus was reached. The Chronic Care Model (CCM) was used to structure the characteristics of the interventions that were identified in the papers. Results: Results show that, in general, prevention and management of CVDs and DM2 in primary care is most likely to be successful when interventions are multifactorial and are provided in a coordinated way by different primary care workers. Furthermore, conditions should be created that enable professionals to incorporate the interventions in their practice routine. It will be a challenge to integrate a heterogeneous mix of activities into a comprehensive chronic care package that includes a major role of selfactivated ('pre’-)patients. Effective interventions and strategies for the prevention and management of CVD and DM2 in primary care will be presented. Features of health care systems will also be taken into account, in particular which options are feasible for countries with a lower level of resources. (aut. ref.)