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. 2020 Dec 4;17(23):9080.
doi: 10.3390/ijerph17239080.

High Variability in Implementation of Selective-Prevention Services for Cardiometabolic Diseases in Five European Primary Care Settings

Christos Lionis  1 , Marilena Anastasaki  1 , Antonios Bertsias  1 , Agapi Angelaki  1 , Axel C Carlsson  2   3 , Hrafnhildur Gudjonsdottir  4 , Per Wändell  2 , Anders Larrabee Sonderlund  5 , Trine Thilsing  5 , Jens Søndergaard  5 , Bohumil Seifert  6 , Norbert Kral  6 , Niek J De Wit  7 , Monika Hollander  7 , Joke Korevaar  8 , François Schellevis  8   9
Affiliations

High Variability in Implementation of Selective-Prevention Services for Cardiometabolic Diseases in Five European Primary Care Settings

Christos Lionis et al. Int J Environ Res Public Health. .

Abstract

(1) Background: Cardiometabolic diseases are the most common cause of death worldwide. As part of a collaborative European study, this paper aims to explore the implementation of primary care selective-prevention services in five European countries. We assessed the implementation process of the selective-prevention services, participants' cardiometabolic profile and risk and participants' evaluation of the services, in terms of feasibility and impact in promoting a healthy lifestyle. (2) Methods: Eligible participants were primary care patients, 40-65 years of age, without any diagnosis of cardiometabolic disease. Two hundred patients were invited to participate per country. The extent to which participants adopted and completed the implementation of selective-prevention services was recorded. Patient demographics, lifestyle-related cardiometabolic risk factors and opinions on the implementation's feasibility were also collected. (3) Results: Acceptance rates varied from 19.5% (n = 39/200) in Sweden to 100% (n = 200/200) in the Czech Republic. Risk assessment completion rates ranged from 65.4% (n = 70/107) in Greece to 100% (n = 39/39) in Sweden. On a ten-point scale, the median (25-75% quartile) of participant-reported implementation feasibility ranged from 7.4 (6.9-7.8) in Greece to 9.2 (8.2-9.9) in Sweden. Willingness to change lifestyle exceeded 80% in all countries. (4) Conclusions: A substantial variation in the implementation of selective-prevention receptiveness and patient risk profile was observed among countries. Our findings suggest that the design and implementation of behavior change cardiometabolic programmes in each country should be informed by the local context and provide some background evidence towards this direction, which can be even more relevant during the current pandemic period.

Keywords: cardio-vascular diseases; cardiometabolic diseases; feasibility study; prevention; primary care; risk reduction.

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Conflict of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The content of this manuscript presents the views of the authors only, and is their sole responsibility.

Figures

Figure 1
Figure 1
Study flow chart in the five European primary care settings.
Figure 2
Figure 2
Participants’ evaluation of the risk assessment intervention. (Participants from Denmark and the Netherlands did not answer evaluation questions, despite their invitation to do so.)
Figure 3
Figure 3
Willingness (A) and barriers (B) towards changing lifestyle among participants accepting risk assessment: (Despite invitation, participants from Denmark and the Netherlands did not answer evaluation questions). Abbreviations: CVD: cardiovascular disease, T2DM: type-II diabetes mellitus.
Figure 3
Figure 3
Willingness (A) and barriers (B) towards changing lifestyle among participants accepting risk assessment: (Despite invitation, participants from Denmark and the Netherlands did not answer evaluation questions). Abbreviations: CVD: cardiovascular disease, T2DM: type-II diabetes mellitus.
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