Clinician Compliance with Primary Prevention of Tobacco Use: The Impact of Social Contingencies

1997 ◽  
Vol 26 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Stergios Russos ◽  
Melbourne F Hovell ◽  
Kristen Keating ◽  
Jennifer A Jones ◽  
Susan M Burkham ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Tobacco Use ◽  
Social Contingencies ◽  
The Impact

scholarly journals The impact of information about tobacco-related reproductive vs. general health risks on South Indian women's tobacco use decisions

2020 ◽  
pp. 1-52
Author(s):  
Caitlyn D. Placek ◽  
Renee E. Magnan ◽  
Vijaya Srinivas ◽  
Poornima Jaykrishna ◽  
Kavitha Ravi ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Health Risks ◽  
General Health ◽  
South Indian ◽  
The Impact

Worldwide differences in primary prevention implantable cardioverter defibrillator utilization and outcomes in hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
Victor Nauffal ◽  
Peter Marstrand ◽  
Larry Han ◽  
Victoria N Parikh ◽  
Adam S Helms ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Primary Prevention ◽  
Implantable Cardioverter Defibrillator ◽  
Cox Proportional Hazards ◽  
Icd Implantation ◽  
Icd Therapy ◽  
Cardioverter Defibrillator ◽  
Significant Difference ◽  
Implantation Rates ◽  
The Impact

Abstract Aims  Risk stratification algorithms for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) and regional differences in clinical practice have evolved over time. We sought to compare primary prevention implantable cardioverter defibrillator (ICD) implantation rates and associated clinical outcomes in US vs. non-US tertiary HCM centres within the international Sarcomeric Human Cardiomyopathy Registry. Methods and results We included patients with HCM enrolled from eight US sites (n = 2650) and five non-US (n = 2660) sites and used multivariable Cox-proportional hazards models to compare outcomes between sites. Primary prevention ICD implantation rates in US sites were two-fold higher than non-US sites (hazard ratio (HR) 2.27 [1.89–2.74]), including in individuals deemed at high 5-year SCD risk (≥6%) based on the HCM risk-SCD score (HR 3.27 [1.76–6.05]). US ICD recipients also had fewer traditional SCD risk factors. Among ICD recipients, rates of appropriate ICD therapy were significantly lower in US vs. non-US sites (HR 0.52 [0.28–0.97]). No significant difference was identified in the incidence of SCD/resuscitated cardiac arrest among non-recipients of ICDs in US vs. non-US sites (HR 1.21 [0.74–1.97]). Conclusion  Primary prevention ICDs are implanted more frequently in patients with HCM in US vs. non-US sites across the spectrum of SCD risk. There was a lower rate of appropriate ICD therapy in US sites, consistent with a lower-risk population, and no significant difference in SCD in US vs. non-US patients who did not receive an ICD. Further studies are needed to understand what drives malignant arrhythmias, optimize ICD allocation, and examine the impact of different ICD utilization strategies on long-term outcomes in HCM.

scholarly journals Impact of acetylsalicylic acid on primary prevention of cardiovascular diseases: A meta-analysis of randomized trials

2018 ◽  
Vol 26 (7) ◽  
pp. 746-749 ◽  
Author(s):  
Sunil Upadhaya ◽  
Seetharamprasad Madala ◽  
Ramkaji Baniya ◽  
Kalyan Saginala ◽  
Jahangir Khan
Keyword(s):  
Primary Prevention ◽  
Acetylsalicylic Acid ◽  
Hemorrhagic Stroke ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Vascular Events ◽  
Individual Participant ◽  
The Cost ◽  
The Impact ◽  
Key Questions

Numerous studies have investigated use of acetylsalicylic acid (ASA) for prevention of cardiovascular deaths. The vast majority of the work in this area has focused on secondary prevention. However, underuse of ASA still remains a major issue. Fewer studies have investigated the impact of ASA on primary prevention of cardiovascular death. A meta-analysis of individual participant data from six randomized studies, published in 2009, showed decrease in serious vascular events but at the cost of causing increased bleeding and hemorrhagic stroke. Recent studies have raised a number of key questions regarding the benefits and risks of using ASA for primary prevention.

scholarly journals Potential Social, Environmental, and Regulatory Threats to Electronic Health Record Strategies for Improving Tobacco Treatment in Healthcare

2013 ◽  
Vol 8 (2) ◽  
pp. 106-114
Author(s):  
Frank T. Leone ◽  
Sarah Evers-Casey ◽  
Michael J. Halenar ◽  
Keiren O'Connell ◽  
Keyword(s):  
Tobacco Use ◽  
Treatment Guidelines ◽  
Topic Area ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Potential Impact ◽  
Electronic Health ◽  
Social Environmental ◽  
The Impact ◽  
Optimal Implementation

Introduction– The potential impact of electronic health records (EHR) in driving tobacco treatment behaviours within healthcare settings has been established. However, little is known about the administrative variables that may undermine effectiveness in real world settings.Aims– Assist healthcare planners interested in implementing tobacco-EHR systems by identifying an EHR framework that is consistent with published treatment guidelines, and the important organisational variables that can undermine the effectiveness of tobacco-EHR.Methods– This paper considers the established literature on EHR implementation and physician behaviour change, and integrates this understanding with the observations of an expert workgroup tasked with facilitating tobacco-EHR implementation in Southeastern Pennsylvania.Results/ Findings– System change in this topic area will continue to be problematic unless attention is paid to several important lessons regarding: 1) the evolving healthcare regulatory environment, 2) the integration of tobacco use treatment into primary care, and 3) the existing social and organisational barriers to uptake of evidence-based recommendations.Conclusion– Healthcare organisations seeking to reduce the impact of tobacco use on their patients are well served by tobacco-EHR systems that improve care. Managers can avoid sub-optimal implementation by considering several threats to effectiveness before proceeding to systems change.

Abstract MP41: Implications of the Use of the New ACC/AHA Guidelines for Cardiovascular Disease Prevention in a Brazilian Cohort - The Elsa Brasil Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Marcio S Bittencourt ◽  
Isabela Bensenor ◽  
Dora Chor ◽  
Paulo Vasconcelos ◽  
Paulo Lotufo
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Prediction Model ◽  
Urban Areas ◽  
Absolute Risk ◽  
Adult Health ◽  
Older Individuals ◽  
Cvd Risk ◽  
The Impact ◽  
Brazilian Cohort

Introduction: The 2013 American College of Cardiology / American Heart Association (ACC/AHA) guidelines developed a new prediction model for cardiovascular disease (CVD) and suggested the use of a lower threshold of 7.5% 10 year hard CVD risk for primary prevention. The implications of the use of this model in other cohort and admixed races has not yet been tested. The current study sought to evaluate the potential impact of its use in a large Brazilian cohort. Methods: We have included 15105 participants of the (Brazilian Longitudinal Study of Adult Health) ELSA-Brasil study, a multicenter prospective study that enrolled civil servants aged 35 to 74 years in 6 different urban areas in brazil. We have calculated the both the Framingham risk score (FRS) and the new risk prediction model to the entire cohort, and estimated the impact of changing current recommendations based on the FRS and lipid targets to the new recommendations based on the absolute risk estimated by the new model. Results: The mean age was 52±9.1 years, with 8218 (54%) women. The race distribution included 52% white, 16% black, 28% mixed (brown), and 4% of other. While 19.2% (95% CI: 18.4 to 19.6) of the cohort would require statins for primary prevention accordion to prior recommendations, the new guidelines would recommend treatment for approximately 40.2% (95%CI: 39.4 to 41.0) of the cohort. A substantial increase in the population in whom statins are recommended occurred for males, from 23.3% (95%CI: 22.6 to 24.0%) to 55.7% (95%CI: 54.9 to 56.5), as well as females, from 16.6 (95%CI: 16.0 to 17.2) to 27.1 (95%CI: 26.4 to 27.8), and across all races and age levels (figure). Conclusion: The new ACC/AHA guidelines for primary prevention would approximately double the proportion of Brazilian adults in whom statins are indicated, mostly among older individuals. The epidemiological and economical impact of this changes are not yet known.

PRIMARY PREVENTION OF DEMENTIA: AN EPIDEMIOLOGICAL POINT OF VIEW

2016 ◽  
pp. 1-4
Author(s):  
C. Berr
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Disease Onset ◽  
Point Of View ◽  
Level Of Evidence ◽  
Life Course Approach ◽  
Important Concern ◽  
Dementia Prevention ◽  
Underlying Mechanisms ◽  
The Impact

From an epidemiological perspective, in order to increase the level of evidence, it is necessary to refer to data from longitudinal studies to validate the temporal relationship between exposure (e.g. the behavior or modifying factor) and the disease. Findings from such studies are useful for defining risk factors and laying the groundwork for proposing interventions for prevention. This step is crucial in order to define the periods (life-course approach) and groups at risk, which will then become the targets of interventions designed to modify behaviors or lifestyle. Specifying the underlying mechanisms of these risk factors is one of the objectives of etiological epidemiology which focuses on the origin of diseases but is not essential for a more pragmatic interventional approach. These questions are essential for dementia prevention and are discussed in this paper. Furthermore, timing interventions is a major problem even if we identify primary prevention pathways in dementia. Another important concern for epidemiologists is the need to make projections to estimate the number of dementia cases in the next decades considering different intervention scenarios. These models require adequate descriptive indicators of dementia, demography and mortality and precise estimations of the impact of potential interventions in terms of delaying disease onset for instance.

The primary prevention of anxiety disorders

2020 ◽  
pp. 948-960
Author(s):  
Aliza Werner-Seidler ◽  
Jennifer L. Hudson ◽  
Helen Christensen
Keyword(s):  
Anxiety Disorder ◽  
Primary Prevention ◽  
Scale Up ◽  
Population Level ◽  
Implementation Barriers ◽  
Cognitive Behavioural ◽  
Post Test ◽  
Prevention Programmes ◽  
Programme Content ◽  
The Impact

This chapter describes the nature of primary prevention of anxiety and reports on evidence for its effectiveness. The chapter first defines prevention before reporting results of a systematic review of randomized controlled trials designed to prevent anxiety. A review of existing trials and associated effect sizes suggests that prevention programmes can be effective in preventing anxiety disorder incidence and symptoms in multiple settings (schools, workplaces, community) across the lifespan. The median effect size at post-test across all studies was 0.21, and 0.25 specifically for cognitive behavioural prevention programmes. Key elements common to prevention programmes are then discussed, including a consideration of programme content and personnel delivering the intervention. Key implementation barriers are raised, together with suggestions for how these might be overcome in order to scale up and offer prevention at a population level. The chapter concludes with a consideration of the impact these programmes could have on anxiety disorder incidence.

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