Title: Cardiovascular disease prevention; impacts of an intervention on clinical practice
Author: Ejiofor A. Ezika, PhD
DOI: https://dx.doi.org/10.18535/jmscr/v9i5.12
Abstract
Aim: To explore approaches to improve healthcare practice associated with reduced cardiovascular disease (CVD) in an urban community setting in Nigeria.
Methods: Snowball sampling was used to recruit ten healthcare workers from a hospital within a community in Lagos State, Nigeria. The researcher collaboratively developed tools with the ten healthcare workers to explore barriers to the prevention of CVD; designed, and implemented approaches to overcome some of the identified modifiable barriers to CVD prevention. Subsequently, the researcher in collaboration with the healthcare workers recruited a total of 22 outpatients in an outpatient clinic in the hospital and explore their knowledge and behaviour in relation to CV health. In collaboration with the healthcare workers, the researcher also developed tools to identify practices of screening for CVD risk factors in relation to the WHO recommendations and implemented approches to improve screening practices.
Results: A wide range of barriers to the prevention of CVD within the community were identified, including knowledge and organisational barriers, medication compliance, cultural and religious beliefs, and socio-economic factors. Some of the approaches adopted by the healthcare workers to address the prevalence of CVD within the community include continuation of health education as it affects the CVD, establishment of smoking cessation programme, and keeping in touch with the patients after they have been discharged from the hospital. Cardiovascular health knowledge among outpatients does not always translate to healthy behaviours. The most screened risk-factor for CVD was blood pressure while the least screened risk-factor for CVD was physical activity.
Conclusion: A research collaboratively planned, designed, facilitated, monitored, and evaluated with healthcare practitioners could be a vital tool to improve healthcare practice. The strategies used in this research could inform policy formulations for healthcare improvement and can be adapted to improve healthcare practice in similar context.
Keywords: Cardiovascular disease, secondary prevention, healthcare practice improvement.
References
- Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome. Circulation. 2005; 112: 2735 - 2752
- Gaal LFV, Mertens IL, Block CE. Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444: 875 – 80
- World Heart Federation. Cardiovascular diseases: risk factors. Available from: https://www.world-heart-federation.org/resources/risk-factors/
- Owolabi TOS, Ezika EA, Lewitt M, Cross B (2016) Communication media and cardiovascular health promotion as factors for sustainable development in Nigeria. JS DA. 2016; 18 (1): 157 – 172
- Robinson L, Stacy R. Palliative care in the community: setting practice guidelines for primary care teams. Br J Gen Pract. 1994, 44: 461 – 464
- Murray SA, Tapson J, Turnbull L, et al. Listening to local voices: adapting rapid appraisal to assess health and social needs in general practice. 1994; 308: 700 -719
- George CE, Ramadas D, Norman G, et al. Barriers to cardiovascular disease risk reduction: does physicians’ perspective matter? Indian Heart J. 2016; 68: 278 – 285
- Ferrante D, Konfino J, Linetzky B, et al. Barriers to prevention of cardiovascular disease in primary care settings in Argentina. Rev Panam Salud Publica. 2013; 33 (4): 259 – 266
- Fleary SA, Joseph P, Pappagianopoulos JE. Adolescents health literacy and health behaviours: a systematic review. J Adolesc. 2018; 62: 116 - 127