The effectiveness of a proven chronic disease prevention and screening intervention in diverse and remote primary care settings: an implementation study on the BETTER 2 Program

BJGP Open

Eva Grunfeld¹  Rahim Moineddin¹  Paul Krueger¹  Julia Baxter¹  Denise Campbell-Scherer²  Donna Manca²  Nicolette Sopcak²  Carolina Fernandes²  Christopher Meaney³  Margo Wilson⁴  Richard Cullen⁵  Carla Penney⁵  Andrea Pike⁵  Kris Aubrey-Bassler⁶ 

[1] Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada;Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada;Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada;Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada;Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Canada;Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John’s, Canada;

关键词: chronic disease;    primary prevention;    early detection of cancer;    disease management;    general practice;    primary care;   

DOI  :  10.3399/bjgpopen19X101656

来源: DOAJ

【 摘 要 】

Background: The Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER) randomised control trial (RCT) showed that the BETTER Program improved chronic disease prevention and screening (CDPS) by 32.5% in urban team-based primary care clinics. Aim: To evaluate outcomes from implementation of BETTER in diverse clinical settings. Design & setting: An implementation study was undertaken to apply the CDPS intervention from the BETTER trial to diverse settings in BETTER 2. Patients aged 40–65 years were invited to enrol in the study from three clinics in Newfoundland and Labrador, Canada. Method: At baseline, eligibility for 27 CDPS actions (for example, cancer, diabetes and hypertension screening, lifestyle) was determined. Patients then met with a trained provider and prioritised goals to address their eligible CDPS actions. Providers received training in behaviour change theory and practice. Descriptive analysis of clinical outcomes and success factors were reported. Results: A total of 154 patients (119 female and 35 male) had a baseline visit; 106 had complete outcome assessments, and the remainder had partial outcome assessments. At baseline, patients were eligible for a mean of 12.3 CDPS actions and achieved a mean of 6.0 (49%, 95% confidence intervals [CI] = 24% to 74%) at 6-month follow-up, including reduced hypertension (86% of eligible patients, 95% CI = 67% to 96%), weight control (51% of eligible patients, 95% CI = 42% to 60%), and smoking cessation (36% of eligible patients, 95% CI = 17% to 59%). Male, highly educated, and lower income individuals achieved a higher proportion of CDPS manoeuvers than their counterparts. Conclusion: Clinical outcomes from this implementation study were comparable with those of the prior BETTER RCT, providing support for the BETTER Program as an effective approach to CDPS in more diverse general practice settings.

【 授权许可】

Unknown