Population and Primary Health Care Characteristics and Coronary Heart Disease Mortality

JAMA ◽  
2011 ◽  
Vol 305 (8) ◽  
pp. 778 ◽  
Author(s):  
Peter Cummings
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Coronary Heart Disease Mortality ◽  
Primary Health ◽  
Disease Mortality

scholarly journals Association of Features of Primary Health Care With Coronary Heart Disease Mortality

JAMA ◽  
2010 ◽  
Vol 304 (18) ◽  
Author(s):  
Louis S. Levene ◽  
Richard Baker ◽  
M. John G. Bankart ◽  
Kamlesh Khunti
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Coronary Heart Disease Mortality ◽  
Primary Health ◽  
Disease Mortality

scholarly journals The effect of problem-based learning after coronary heart disease – A randomised study in primary health care (COR-PRIM)

2019 ◽  
Author(s):  
Anita Kärner Köhler ◽  
Tiny Jaarsma ◽  
Pia Tingström ◽  
Staffan Nilsson
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Patient Information ◽  
Patient Empowerment ◽  
Problem Based Learning ◽  
Primary Health ◽  
One Year ◽  
Experimental Group

Abstract Background The hypothesis tested was that one year of problem-based learning (PBL) improves patients’ self-efficacy, and empowerment to change self-care significantly compared to one year of standardised home-sent patient information after an event of coronary heart disease (CHD). Methods We randomly assigned 157 patients (78% male; age 68±8.5 years) with CHD verified by percutaneous coronary intervention (PCI) (70.1%) or coronary artery by-pass surgery (CABG) and CABG+PCI or myocardial infarction (29.9%) to either PBL (experimental group; n = 79) or home-sent patient information group (controls; n = 78). The PBL intervention consisted of a patient education in primary health care by trained district nurses who tutored groups of 6-9 patients on 13 occasions over one year. Controls received home- sent patient information on 11 occasions during the study year. Results At the one-year follow-up, the primary outcome, patient empowerment, did not significantly differ between the experimental group and controls. We found no significant differences between the groups regarding the secondary outcomes e.g. self-efficacy, although we found significant differences for body mass index (BMI) [-0.17 (SD 1.5) vs. 0.50 (SD 1.6), P=0.033 ], body weight [-0.83 (SD 4.45 vs. 1.14 kg (SD 4.85), P=0.026 ] and HDL cholesterol [0.1 (SD 0.7) vs. 0.0 mmol/L (SD 0.3), P=0.038 ] for the experimental group compared to controls. Conclusions The PBL and the home-sent patient information interventions had similar results regarding patient empowerment. However, PBL exhibited significant effects on weight loss, BMI, and HDL cholesterol levels, indicating that the PBL intervention positively affected risk factors compared to the home-sent patient information intervention. Trial registration : NCT01462799 (August 2019, date last accessed) Keywords: Problem-based learning, Coronary Heart Disease, Primary Health Care, Patient empowerment, Risk factors, Self-care

scholarly journals Secondary Prevention of Coronary Heart Disease in Primary Health Care

2006 ◽  
Vol 6 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Olivera Batić-Mujanović ◽  
Muharem Zildžić ◽  
Azijada Beganlić
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Secondary Prevention ◽  
Ace Inhibitors ◽  
Lipid Lowering ◽  
Primary Health

Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention(serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.

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