The Role of Primary Care in the Organization of Evidence-based Preventive Measures
##plugins.themes.bootstrap3.article.main##
Abstract
The concept of evidence-based prevention is widespread, the embodiment of which is envisaged at the level of primary medical care (PMP), which determined the relevance of the study.
The objective: is to evaluate assess the role of the primary level in the organization of preventive measures based on evidence based on the opinions of the heads of the PMP institutions.
Materials and methods. The research was conducted among 52 organizers of primary health care in the Dnipropetrovsk region. Used independently developed questionnaire. Processing of the results was carried out using standard statistical procedures.
Results. The respondents were fairly knowledgeable about the evidence for common screening tests. The degree of awareness of the managers of PMP institutions in conducting preventive examinations with proven effectiveness correlates with their use in everyday practice (Spearman’s correlation coefficient ρ=0,38; p<0,05). When organizing preventive measures at the primary level, according to the majority of the interviewed managers (92,3%), they rely mainly on clinical protocols for certain ontologies. The list of preventive medical examinations, approved by the new procedure for the provision of PMP, is still not actively used (38,5%). This is due both to the shortcomings of the existing regulatory information on conducting effective screening (42,3% of respondents) and to a certain inconsistency of the provisions of the regulatory act with the USPSTF recommendations.
Conclusions. In the conditions of imperfection of the regulatory framework for screening research based on evidence, it is necessary to introduce a new approach to the organization and conduct of preventive measures in the paradigm of evidence-based prevention. The implementation of proven effective preventive measures should be implemented at the level of primary health care, with its active participation and coordinating role, collaboration with the public health and e-Health.##plugins.themes.bootstrap3.article.details##
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Аналіз перешкод на шляху розвитку системи первинної медичної допомоги в Україні та можливі підходи до їх подолання / [В.М. Лехан, Л.В. Крячкова, Е.В. Борвінко, В.В. Волчек] // Медичні перспективи. – 2016. – Т. XXI, № 2 (ч. 1). – С. 9–16.
Аргументы в пользу инвестиций в общественное здоровье. Краткий доклад по вопросам общественного здравоохранения для ОФОЗ-8 / [ЕРБ ВОЗ]. – Копенгаген: Региональное издательство ВОЗ, 2014. – 40 с.
Лехан В.М. Доказова профілактика в роботі лікаря загальної практики – сімейного лікаря / Лехан В.М., Крячкова Л.В., Гриценко Л.О. // Сучаснi медичнi технології. – 2017. – № 4. – С. 60–66. PDF
Лехан В.М. Порівняльний аналіз підходів до профілактики в Європі та Україні / В.М. Лехан, Л.В. Крячкова, О.П. Максименко [та ін.] // Україна. Здоров’я нації. – 2017. – № 3. – С. 159–165.
Максимова Ж.В. Скрининг: современный взгляд на раннюю диагностику и профилактику хронических неинфекционных заболеваний / Ж.В. Максимова, Д.М. Максимов // Архивъ внутренней медицины. – 2014. – № 6 (20). – С. 52–56. https://doi.org/10.20514/2226-6704-2014-0-6-52-57
Матюха Л. (Без)Порядок надання первинної медичної допомоги: хто буде крайнім? / Л. Матюха, К. Надутий, Ю. Зінчук // Ваше здоров’я. 23/03/2018. – Електронний ресурс. – Порядок доступу: https://www.vz.kiev.ua/bez-poryadok-nadannya-pervynnoyi-medychnoyi-dopomogy-hto-bude-krajnim/
Первичная медико-санитарная помощь: сегодня актуальнее, чем когда-либо. Доклад о состоянии здравоохранения в мире / [Всемирная организация здравоохранения]. – Женева: ВОЗ, 2008. – 125 с. PDF
Пузанова О.Г. Доказова медична профілактика: міжнародний досвід / О.Г. Пузанова // Семейная медицина. – 2016. – № 6 (68). – С. 34–37.
European Guidelines on cardiovascular disease prevention in clinical practice / M.F. Piepoli, A.W. Hoes, S. Agewall [et al.] // European Heart Journal. – 2016. – № 37 (29). – Р. 2315–2381. https://doi.org/10.1093/eurheartj/ehw106
Aron D.C. From Evidence-based Medicine to Evidence-based Management (and Policy)? / D.C. Aron // Medical Care. – № 53 (6). – 477–479. https://doi.org/10.1097/MLR.0000000000000374
Brownson R.C. Evidence-based public health: a fundamental concept for public health practice / R.C. Brownson, J.E. Fielding, C.M. Maylahn // Annu Rev Public Health. – 2009. – № 30. – Р. 175–201. https://doi.org/10.1146/annurev.pu.30.031709.100001
Building primary care in a changing Europe: case studies / [D.S. Kringos, W.G.W. Boerma, A. Hutchinson, R.B. Saltman]. – World Health Organization: European Observatory on Health Systems and Policies, 2015. – 315 p. PDF
Lall D. Organization of primary health care for diabetes and hypertension in high, low and middle income countries / D. Lall, D. Prabhakaran // Expert Rev Cardiovasc Ther. – 2014. – № 12 (8). – Р. 987–995. https://doi.org/10.1586/14779072.2014.928591
USPSTF A and B Recommendations / [USPSTF] // Електронний ресурс. – Порядок доступу: https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/