Перегляд за Автор "Titkova, Anna"

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Knowledge and application of cardiovascular disease prevention guidelines among family physicians: a cross-sectional study
(Skopje-Warsaw : Scientific Foundation SPIROSKI, Sciendo, 2021) Korzh, Oleksii; Nikolenko, Yevgenii; Titkova, Anna; Lavrova, Yelizaveta; Vovk, Kira
BACKGROUND: Family physicians (FPs) play an important role in the prevention of cardiovascular disease (CVD). AIM: This study aims to assess the determinants of FPs’ knowledge and application of cardiovascular preventive management guidelines at primary health-care setting in Ukraine. MATERIALS AND METHODS: We performed a cross-sectional study conducted among the 226 FPs in Kharkiv Region, Ukraine. A self-administrated questionnaire was administered, exploring demographic, job characteristics, knowledge of CVD prevention guidelines, and application of CVD guidelines’ questions about the essential items related to diagnosis and management of CVD according to the international/local guidelines. RESULTS: The results show a very low level of knowledge of guidelines among FPs with 85.8% scoring below the acceptable knowledge level. The guidelines were applied below the acceptable level with 51.3% scoring below the cutoff point. The results indicate that both average scores were below the minimum acceptable level. Lack of knowledge of the CVD preventive care was considered the biggest barrier (62.8%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%). CONCLUSIONS: Recognizing the low level of knowledge and application of guidelines among primary care providers and working toward minimizing this problem can be through education, training, and monitoring of the application. This can potentially improve CVD preventive management among patients.
The long-term clinical outcomes in patients after myocardial infarction in primary care
(Mangalore : Light House Polyclinic, 2021-06-30) Korzh, Oleksii; Nikolenko, Yevgenii; Titkova, Anna; Pavlova, Olena; Vovk, Kira
The aim of this study was to investigate the effect of continuous multifaceted patient-centered interventions at primary care level in patients with myocardial infarction (MI) after discharge on achieving clinical practice guideline goals and reducing the rate of hospital readmissions for cardiovascular diseases. Methods: This prospective randomized clinical study was conducted enrolled patients with MI from January 2, 2017 to December 31, 2019. Patients received medication reconciliation and education from a family physician before hospital discharge. The intervention group (IG) received continuous consultations from the family physician after discharge, whereas the control group (CG) did not. Primary outcomes included achieving blood pressure < 140/90 mmHg, low-density lipoprotein-cholesterol (LDL-C) < 70 mg/dL, and hemoglobin A1c (HbA1c) < 7% targets. The secondary outcome was major adverse cardiac events (MACEs), defined as re-hospitalization due to MI, unstable angina and stroke. Results: Two hundred and nineteen patients completed the study protocol (110 in the IG and 109 in the CG). The rate of achieving blood pressure goal was similar between the two groups. More patients in the IG achieved LDL-C and HbA1c goals than those in the CG at 1 year and 2 years post discharge. However, there was no significant difference in the cumulative incidence of MACEs between the two groups. Diabetes was the only independent predictor of rehospitalization due to a MACE. Conclusions: Family physicians interventions led to a higher rate of optimal controlled modifiable risk factors but did not significantly reduce the MACE rate in the patients with MI.