Could primary care dietary intervention combined with lifestyle changes be effective in the cardiovascular prevention?

Móczár, C.; Borgulya, Gábor; Kovács, Eszter; Rurik, Imre

doi:10.1556/aalim.41.2012.2.11

Cited by 8 publications

(7 citation statements)

References 19 publications

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“…Almost 10 % of Hungarian GPs in practice were questioned so their answer could be considered as representative. Distribution of the practice population of the questioned doctors was similar to the estimated Hungarian prevalence of obesity [ 1 , 2 , 26 - 28 ].…”

Section: Discussionsupporting

confidence: 61%

Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians

et al. 2013

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BackgroundObesity, a threatening pandemic, has an important public health implication. Before proper medication is available, primary care providers will have a distinguished role in prevention and management. Their performance may be influenced by many factors but their personal motivation is still an under-researched area.MethodsThe knowledge, attitudes and practice were reviewed in this questionnaire study involving a representative sample of 10% of all Hungarian family physicians. In different settings, 521 practitioners (448 GPs and 73 residents/vocational trainees) were questioned using a validated questionnaire.ResultsThe knowledge about multimorbidity, a main consequence of obesity was balanced.Only 51% of the GPs were aware of the diagnostic threshold for obesity; awareness being higher in cities (60%) and the highest among residents (90%). They also considered obesity an illness rather than an aesthetic issue.There were wider differences regarding attitudes and practice, influenced by the the doctors’ age, gender, known BMI, previous qualification, less by working location.GPs with qualification in family medicine alone considered obesity management as higher professional satisfaction, compared to physicians who had previously other board qualification (77% vs 68%). They measured their patients’ waist circumference and waist/hip ratio (72% vs 62%) more frequently, provided the obese with dietary advice more often, while this service was less frequent among capital-based doctors who accepted the self-reported body weight dates by patients more commonly. Similar reduced activity and weight-measurement in outdoor clothing were more typical among older doctors.Diagnosis based on BMI alone was the highest in cities (85%). Consultations were significantly shorter in practices with a higher number of enrolled patients and were longer by female providers who consulted longer with patients about the suspected causes of developing obesity (65% vs 44%) and offered dietary records for patients significantly more frequently (65% vs 52%). Most of the younger doctors agreed that obesity management was a primary care issue.Doctors in the normal BMI range were unanimous that they should be a model for their patients (94% vs 81%).ConclusionMore education of primary care physicians, available practical guidelines and higher community involvement are needed to improve the obesity management in Hungary.

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Section: Discussionsupporting

confidence: 61%

Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians

et al. 2013

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“…266 patients were classified into high cardiovascular risk group on the basis of SCORE assessment (cardiovascular risk 5% or more). There were more men (252) in the high risk group than women ( 14 ).…”

Section: Resultsmentioning

confidence: 99%

“…The description of this wider context of collaboration was beyond the scope of this paper. One of the goals of the managed care system of the NHIFA between 1999 and 2009 was that health case managers were expected to organize public health programs for their patients ( 14 ). Within the framework of the Managed Care System we focused on screening for cardiovascular diseases in Kecskemét and its region.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cardiovascular Risk Screening Methods and Mortality Data Among Hungarian Primary care Population: Preliminary Results of the First Government-Financed Managed care Program / Primerjava Metod Presejanja Ogroženosti Srčno-Žilnega Sistema In Podatkov O Smrtnosti Madžarskega Prebivalstva Z Osnovno Zdravstveno Oskrbo: Predhodni Rezultati Prvega Programa Vodene Oskrbe, Ki Ga Je Financirala Vlada

Móczár¹,

Rurik

2015

Slovenian Journal of Public Health

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IntroductionBesides participation in the primary prevention, screening as secondary prevention is an important requirement for primary care services. The effect of this work is influenced by the characteristics of individual primary care practices and doctors’ screening habits, as well as by the regulation of screening processes and available financial resources. Between 1999 and 2009, a managed care program was introduced and carried out in Hungary, financed by the government. This financial support and motivation gave the opportunity to increase the number of screenings.Method4,462 patients of 40 primary care practices were screened on the basis of SCORE risk assessment. The results of the screening were compared on the basis of two groups of patients, namely: those who had been pre-screened (pre-screening method) for known risk factors in their medical history (smoking, BMI, age, family cardiovascular history), and those randomly screened. The authors also compared the mortality data of participating primary care practices with the regional and national data.ResultsThe average score was significantly higher in the pre-screened group of patients, regardless of whether the risk factors were considered one by one or in combination. Mortality was significantly lower in the participating primary practices than had been expected on the basis of the national mortality data.ConclusionThis government-financed program was a big step forward to establish a proper screening method within Hungarian primary care. Performing cardiovascular screening of a selected target group is presumably more appropriate than screening within a randomly selected population. Both methods resulted in a visible improvement in regional mortality data, though it is very likely that with pre-screening a more cost-effective selection for screening may be obtained.

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“…It may be argued empirically that no amount of physical exercise can overcome the powerful influence of an extremely atherogenic diet such as traditional Hungarian fare. One recent study (Móczár, Borgulya, Kovács, Rurik, 2012) addressed the challenge of presenting a practical summation of primary care prevention strategies for CHD risk amongst a Hungarian population in the Hungarian countryside (2,489 adult patients of 29 primary care physicians between April 2004 and April 2006), which examined the interrelated influence of diet and lifestyle in the management of cardiovascular disease risk. Since this was a large-scale epidemiological investigation conducted by Hungarian researchers working with Hungarian primary care providers treating Hungarian patients, a lack of cultural understanding could not be reasonably postulated as a limitation in study design and implementation.…”

Section: Discussionmentioning

confidence: 99%

Addressing Cardiovascular Disease Risk in HungarianAmerican Populations: A Cultural Exploration of Transdisciplinary Health Promotion

Laszlo

Aboul‐Enein

Bernstein

et al. 2017

Central European Journal of Sport Sciences and Medicine

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Hungarian Americans share a unique culture of food traditions associated with their value system and way of life.Researchers, health care providers, and nutrition professionals counseling and treating a Hungarian-American population should develop a baseline of cultural understanding to achieve successful and long-lasting behavior change outcomes. The leading causes of death among Hungarians include ischemic heart disease (21.3%), stroke (13.4%), and cirrhosis (5.8%); all are directly or indirectly attributed to a traditional Hungarian diet coupled with a sedentary lifestyle. Health behaviors among Hungarian Americans can be partially explained by the Health Belief Model's value-expectancy construct. Understanding cultural expectations and their associated values serve as a foundation for health promotion programming to reduce risk of cardiovascular disease and comorbidities. This review explored numerous facets of Hungarian-American dietary habits in psychosocial, economic, historical, and cultural contexts. Health education and health promotion considerations were also examined.

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Could primary care dietary intervention combined with lifestyle changes be effective in the cardiovascular prevention?

Cited by 8 publications

References 19 publications

Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians

Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians

Addressing Cardiovascular Disease Risk in HungarianAmerican Populations: A Cultural Exploration of Transdisciplinary Health Promotion

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