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.

Introduction: It is important to emphasize that for most patients with type 2 diabetes mellitus (T2DM), an integrated approach to managing risk factors or the simultaneous modification of all increased risk factors is needed to help reduce the risk of cardiovascular events. Achieving an optimal level of glycated hemoglobin (HbA1c), blood pressure (BP) and LDL cholesterol (LDL) in patients softens macro-and microvascular complications, which is the main goal of treatment in the treatment of type 2 diabetes. This study was aimed at determining the proportion of patients with type 2 diabetes and the aforementioned variable conditions that achieve the triple goals of vascular treatment, based on current practical recommendations. Methods: A questionnaire was distributed to adult patients with T2DM and dyslipidemia at primary care clinics in Ukraine. The demographic and clinical data for these patients with both T2DM and dyslipidemia were compared with laboratory data and treatment data obtained from their medical records. The pooled data was then analyzed to determine the proportion of patients who achieved the triple treatment goals, and logistic regression analysis was used to identify the factors associated with this outcome. Results: 715 eligible patients were recruited [58.9% women] with an average age of 59.8 years. Of these patients, 71.2% achieved LDL-C ≤ 2.6 mmol / L, 70.1% had BP <140/90 mm Hg, and 41.2% reached HbA1c <6.5%. Overall, 23.1% achieved the triple goal of treating glycemia, blood pressure and LDL control. The main determinants were the number of diabetic drugs and the intensity of statin therapy. Conclusion: Eight out of ten patients with diabetes mellitus could not achieve the simultaneous goals of treating glycemia, blood pressure and LDL, putting them at risk for vascular complications. Primary health care professionals can reduce these risks by optimizing therapeutic treatment to maximize glycemia, dyslipidemia, and blood pressure control.

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Aim: This study was to investigate the relationships among health behaviors and quality of life (QOL) and to test a proposed model among people with hypertension and concomitant chronic kidney disease (CKD) in primary care. In addition, the mediation effect of modifiable risk factors between self-care health behaviors and QOL was examined. Methods: This study was prospective, conducted in the centers of primary medical care in the period from January 2018 to January 2020. In total, 170 patients diagnosed with hypertension and CKD at least 12 months previously were included in this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument). Results: Self-efficacy had a significantly positive direct effect on self-care health behaviors, with a standardized regression coefficient of 0.87 (P = 0.007), a negative indirect effect on risk factors, with a standardized regression coefficient of 0.11 (P = 0.006), and a positive indirect effect on QOL, with a standardized regression coefficient of 0.62 (P = 0.008). Self-care health behaviors had a significantly positive direct effect on QOL, with a standardized regression coefficient of 0.72 (P = 0.012); there was also an indirect effect of 0.053 (P = 0.004). The direct effect of risk factors on QOL was significant, with a standardized regression coefficient of 0.44 (P = 0.018). The direct effect of self-care health behaviors on QOL was 0.77 (P = 0.008), which has been reduced to 0.72 (P = 0.012). The reduced effect of 0.05 was significant (P = 0.004), confirming the mediating role of modified risk factors. Conclusions: This study indicates health-promoting behaviors in hypertensive patients with CKD have a potential impact on their QOL in primary care. Primary care physicians should focus on motivation strategies to encourage individuals to perform self-care health-promoting behaviors associated with the improved QOL, in order to achieve better outcomes in risk factor management.