Multicomponent intervention provided by GPs to reduce cardiovascular risk factors: evaluation in an Italian large sample

Author:

Colombo Alessandra1,Voglino Gianluca2,Lo Moro Giuseppina2,Taborelli Stefano3,Bianchi Maria Antonietta3,Gutierrez Lucas Maria3,Bert Fabrizio24,Della Rosa Maria Cristina3,Siliquini Roberta24

Affiliation:

1. ATS Milano Città Metropolitana (Agenzia di Tutela Della Salute), Milan, Italy

2. Department of Public Health Sciences, University of Turin, Turin, Italy

3. ATS Insubria (Agenzia di Tutela Della Salute), Varese, Italy

4. A.O.U City of Health and Science of Turin, Turin, Italy

Abstract

Abstract Background The cardiovascular risk increases in a multiplicative way when patients present more risk factors simultaneously. Moreover, the General Practitioners (GPs) play a crucial role in risk factors prevention and reduction. This work aimed to evaluate a multicomponent intervention in the Primary Care Department in an Italian Local Health Unit. Methods A pre-post study was conducted in Northern Italy (2018). Patients were eligible if: aged between 30 and 60 years, not chronic patients, not affected by hypertension or hypercholesterolaemia. The GPs assessed body mass index, hypertension, abdominal obesity, low-density lipoprotein (LDL) values, glycaemic values, smoking and exercise habit (T0). A counselling by GPs to at-risk patients and a multicomponent health education intervention were performed. Reassessment occurred after at least 3 months (T1). Main analyses were chi-squared tests for gender differences, McNemar or marginal homogeneity tests for changes in paired data (P < 0.05 as significant). Results Participants were 5828 at T0 (54.0% females) and 4953 at T1 (53.4% females). At T0, 99.1% presented at least one risk factor. Significant changes in paired data were reported for each risk factor. The greatest improvement frequencies occurred in glycaemia values (51.0%) and hypertension (45.6%), the lowest in abdominal obesity (3.7%). Some differences were recorded between genders, e.g. females reported higher improvement frequencies in hypertension (P = 0.001) and abdominal obesity (P < 0.001), whereas males in physical activity (P = 0.011) and LDL values (P = 0.032). Conclusion The results showed significant changes for each risk factor, both for men and women. GPs and multicomponent educational interventions could play a key role in reducing cardiovascular risk factors.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

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