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What should selective cardiometabolic prevention programmes in European primary care look like?: A consensus-based design by the SPIMEU group
Charles Univ Prague, Fac Med 1, Inst Gen Practice, Albertov 7, Prague 12800, Czech Republic.
Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Dept Gen Practice, Utrecht, Netherlands.
Nivel Netherlands Inst Hlth Serv Res, Utrecht, Netherlands;Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Gen Practice & Elderly Care Med, Med Ctr, Amsterdam, Netherlands.
Nivel Netherlands Inst Hlth Serv Res, Utrecht, Netherlands.
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2019 (English)In: European Journal of General Practice, ISSN 1381-4788, E-ISSN 1751-1402, Vol. 25, no 3, p. 101-108Article in journal (Refereed) Published
Abstract [en]

Background: Selective prevention of cardiometabolic diseases (CMD)-that is, preventive measures specifically targeting the high-risk population-may represent the most effective approach for mitigating rising CMD rates.

Objectives: To develop a universal concept of selective CMD prevention that can guide implementation within European primary care.

Methods: Initially, 32 statements covering different aspects of selective CMD prevention programmes were identified based on a synthesis of evidence from two systematic literature reviews and surveys conducted within the SPIMEU project. The Rand/UCLA appropriateness method (RAM) was used to find consensus on these statements among an international panel consisting of 14 experts. Before the consensus meeting, statements were rated by the experts in a first round. In the next step, during a face-to-face meeting, experts were provided with the results of the first rating and were then invited to discuss and rescore the statements in a second round.

Results: In the outcome of the RAM procedure, 28 of 31 statements were considered appropriate and three were rated uncertain. The panel deleted one statement. Selective CMD prevention was considered an effective approach for preventing CMD and a proactive approach was regarded as more effective compared to case-finding alone. The most efficient method to implement selective CMD prevention systematically in primary care relies on a stepwise approach: initial risk assessment followed by interventions if indicated.

Conclusion: The final set of statements represents the key characteristics of selective CMD prevention and can serve as a guide for implementing selective prevention actions in European primary care.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2019. Vol. 25, no 3, p. 101-108
Keywords [en]
Selective prevention, cardiometabolic disease, primary care, general practice, consensus development
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:uu:diva-396112DOI: 10.1080/13814788.2019.1641195ISI: 000481277800001PubMedID: 31411091OAI: oai:DiVA.org:uu-396112DiVA, id: diva2:1367089
Available from: 2019-10-31 Created: 2019-10-31 Last updated: 2019-10-31Bibliographically approved

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