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*Dagens forskningsoversigt fra Scias Update:*
Are interventions to increase the uptake of screening for cardiovascular
disease risk factors effective? A systematic review and meta-analysis.
BMC Fam Pract. 2017 Jan 17;18(1):4
Authors: Cheong AT, Liew SM, Khoo EM, Mohd Zaidi NF, Chinna K
Abstract
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death
globally. However, many individuals are unaware of their CVD risk factors.
The objective of this systematic review is to determine the effectiveness
of existing intervention strategies to increase uptake of CVD risk factors
screening.
METHODS: A systematic search was conducted through Pubmed, CINAHL, EMBASE
and Cochrane Central Register of Controlled Trials. Additional articles
were located through cross-checking of the references list and bibliography
citations of the included studies and previous review papers. We included
intervention studies with controlled or baseline comparison groups that
were conducted in primary care practices or the community, targeted at
adult populations (randomized controlled trials, non-randomized trials with
controlled groups and pre- and post-intervention studies). The
interventions were targeted either at individuals, communities, health care
professionals or the health-care system. The main outcome of interest was
the relative risk (RR) of screening uptake rates due to the intervention.
RESULTS: We included 21 studies in the meta-analysis. The risk of bias for
randomization was low to medium in the randomized controlled trials, except
for one, and high in the non-randomized trials. Two analyses were
performed; optimistic (using the highest effect sizes) and pessimistic
(using the lowest effect sizes). Overall, interventions were shown to
increase the uptake of screening for CVD risk factors (RR 1.443; 95% CI
1.264 to 1.648 for pessimistic analysis and RR 1.680; 95% CI 1.420 to 1.988
for optimistic analysis). Effective interventions that increased screening
participation included: use of physician reminders (RR ranged between
1.392; 95% CI 1.192 to 1.625, and 1.471; 95% CI 1.304 to 1.660), use of
dedicated personnel (RR ranged between 1.510; 95% CI 1.014 to 2.247, and
2.536; 95% CI 1.297 to 4.960) and provision of financial incentives for
screening (RR 1.462; 95% CI 1.068 to 2.000). Meta-regression analysis
showed that the effect of CVD risk factors screening uptake was not
associated with study design, types of population nor types of
interventions.
CONCLUSIONS: Interventions using physician reminders, using dedicated
personnel to deliver screening, and provision of financial incentives were
found to be effective in increasing CVD risk factors screening uptake.
PMID: 28095788
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
<https://www.ncbi.nlm.nih.gov/home/about/policies>.
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