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Patient reports of lifestyle advice in primary care.

https://arctichealth.org/en/permalink/ahliterature120901
Source
Can J Diet Pract Res. 2012;73(3):122-7
Publication Type
Article
Date
2012
Author
Paula M Brauer
Lee Anne Sergeant
Bridget Davidson
Rick Goy
Linda Dietrich
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada.
Source
Can J Diet Pract Res. 2012;73(3):122-7
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Health Behavior
Health Communication - methods
Humans
Life Style
Male
Middle Aged
Ontario
Physician's Practice Patterns - statistics & numerical data
Preventive Medicine - methods - statistics & numerical data
Primary Health Care - methods
Questionnaires
Abstract
Patients' perceptions of preventive lifestyle in primary care practice were examined.
Practice was assessed with a modified version of the Primary Care Assessment Survey (PCAS). This was mailed to random samples of patients twice, using practice mailing lists from three Ontario Family Health Networks (FHNs). Family Health Networks are physician-based group practices, with additional nurse-led telephone advisory services to provide care 24 hours a day, seven days a week. The PCAS questionnaire consisted of nine scales (ranging from 0 to 100). For preventive counselling, additional questions on diet and exercise counselling were included to determine how the physician delivered the intervention.
Of the 2184 survey questionnaires mailed to patients, 22% were undeliverable. The response rate was 62% at valid addresses (49% of all mailed questionnaires). Of the nine scales, scores (± standard deviation) for preventive counselling were lowest at 33 ± 25. In particular, rates of diet (37%) and exercise (24%) counselling were low in the FHNs. For most other aspects of primary care services, patients generally rated FHNs highly. The majority of patients advised about diet and exercise were given verbal advice or pamphlets.
In these primary health care organizations, considerable room exists for increased preventive counselling, especially about diet and exercise.
PubMed ID
22958629 View in PubMed
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The population approach to stroke prevention: a Canadian perspective.

https://arctichealth.org/en/permalink/ahliterature185575
Source
Clin Invest Med. 2003 Apr;26(2):78-86
Publication Type
Article
Date
Apr-2003
Author
T Kue Young
Vladimir Hachinski
Author Affiliation
Department of Public Health Sciences, University of Toronto, Toronto, Ont. kue.young@utoronto.ca
Source
Clin Invest Med. 2003 Apr;26(2):78-86
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Female
Health Resources - organization & administration - statistics & numerical data
Health Services - statistics & numerical data
Humans
Male
Population Surveillance
Preventive Medicine - methods - statistics & numerical data
Public Health
Risk factors
Stroke - epidemiology - mortality - prevention & control
Abstract
To contrast the population and clinical approaches to stroke prevention and to review Canadian data relevant to estimating disease burden, assessing risk factors, designing preventive strategies and organizing health services.
A narrative review of the published literature and statistical data accessible through the Internet.
Unlike the clinical approach, which emphasizes individual patients at high risk diagnosed and treated intensively, usually by medical or surgical means (or both), a population approach focuses on the entire population and bases interventions on behavioural and environmental changes. Stroke offers a particularly promising target for prevention. It represents a leading cause of serious disability, death and reduced quality of life. The aging of our population threatens to increase the already considerable burden. Stroke shares several risk factors with other chronic diseases, especially ischemic heart disease. These risk factors vary in their impact on Canadians (population attributable risk proportion), which is a function of their prevalence and strength of association with the occurrence of stroke. Although effective preventive measures are available for people at high risk, they are not being applied systematically among potential beneficiaries. Small reductions in the exposure to risk factors in the entire population offer an alternative, where even modest success may translate into major gain.
The clinical and population approaches to stroke prevention are complementary. Existing national strategies directed at promotion of healthy life-styles (especially physical activity) and hypertension control, when fully implemented, will reduce the frequency, severity and impact of stroke on Canadian society.
PubMed ID
12722841 View in PubMed
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The use of lipid-lowering therapy for secondary prevention in patients undergoing percutaneous coronary intervention.

https://arctichealth.org/en/permalink/ahliterature169587
Source
Can J Cardiol. 2006 Apr;22(5):419-23
Publication Type
Article
Date
Apr-2006
Author
Jessica M Ma
Cynthia A Jackevicius
Uchenwa Genus
Vladimir Dzavik
Author Affiliation
Pharmacy Department, Toronto East General Hospital, Canada. jesma@tegh.on.ca
Source
Can J Cardiol. 2006 Apr;22(5):419-23
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Age Distribution
Angioplasty, Balloon, Coronary - statistics & numerical data
Cardiology - statistics & numerical data
Female
Humans
Hypercholesterolemia - complications - drug therapy
Hypolipidemic Agents - therapeutic use
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - complications - therapy
Ontario
Preventive Medicine - methods - statistics & numerical data
Process Assessment (Health Care)
Recurrence
Sex Distribution
Abstract
Recent literature suggests that lipid-lowering therapy may have an early beneficial effect among patients undergoing percutaneous coronary intervention (PCI) because the therapy decreases cardiac mortality, morbidity and possibly restenosis.
The primary objective of the present study was to determine the proportion of PCI patients receiving lipid-lowering therapy at a large, tertiary-care referral centre.
Patients undergoing a first PCI between August 2000 and August 2002 with corresponding inpatient medication information were included in the study. Patient demographics, procedural variables, and lipid-lowering and other evidence-based cardiac medication data were collected. A multiple logistical regression model was constructed to evaluate the factors associated with the use of lipid-lowering therapy.
Of the 3254 cases included in the analyses, 52% were elective, 44% were urgent or salvage, and 4% were emergent. The mean patient age was 63 years, and 73% of patients were male. Over 76% of patients were receiving lipid-lowering therapy at the time of PCI. Patient use of other medications was as follows: acetylsalicylic acid in 96%, beta-blocker in 80% and angiotensin-converting enzyme inhibitor in 59%. In the multiple regression analysis, variables significantly associated with lipid-lowering therapy use included hypercholesterolemia, beta-blocker use, angiotensin-converting enzyme inhibitor use, case urgency, prior coronary artery bypass graft surgery, age and sex.
Lipid-lowering therapy use rates exceeded those previously reported in the literature. Women and patients undergoing elective procedures appear to be treated less often with lipid-lowering therapy. There remains an opportunity to further optimize use in this high-risk cohort at time of PCI.
Notes
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PubMed ID
16639478 View in PubMed
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