Population health interventions for cardiometabolic diseases in primary care: a scoping review and RE-AIM evaluation of current practices

Margot Rakers; Nicoline van Hattem; Sabine Plag; Niels Chavannes; Hendrikus J A van Os; Rimke C Vos

doi:10.3389/fmed.2023.1275267

Population health interventions for cardiometabolic diseases in primary care: a scoping review and RE-AIM evaluation of current practices

Front Med (Lausanne). 2024 Jan 4:10:1275267. doi: 10.3389/fmed.2023.1275267. eCollection 2023.

Authors

Margot Rakers¹, Nicoline van Hattem¹, Sabine Plag², Niels Chavannes¹, Hendrikus J A van Os¹, Rimke C Vos²

Affiliations

¹ Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands.
² Health Campus the Hague, Leiden University Medical Center, The Hague, Netherlands.

Abstract

Introduction: Cardiometabolic diseases (CMD) are the leading cause of death in high-income countries and are largely attributable to modifiable risk factors. Population health management (PHM) can effectively identify patient subgroups at high risk of CMD and address missed opportunities for preventive disease management. Guided by the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework, this scoping review of PHM interventions targeting patients in primary care at increased risk of CMD aims to describe the reported aspects for successful implementation.

Methods: A comprehensive search was conducted across 14 databases to identify papers published between 2000 and 2023, using Arksey and O'Malley's framework for conducting scoping reviews. The RE-AIM framework was used to assess the implementation, documentation, and the population health impact score of the PHM interventions.

Results: A total of 26 out of 1,100 studies were included, representing 21 unique PHM interventions. This review found insufficient reporting of most RE-AIM components. The RE-AIM evaluation showed that the included interventions could potentially reach a large audience and achieve their intended goals, but information on adoption and maintenance was often lacking. A population health impact score was calculated for six interventions ranging from 28 to 62%.

Discussion: This review showed the promise of PHM interventions that could reaching a substantial number of participants and reducing CMD risk factors. However, to better assess the generalizability and scalability of these interventions there is a need for an improved assessment of adoption, implementation processes, and sustainability.

Keywords: RE-AIM framework; cardiometabolic diseases; modifiable risk factors; population health impact score; population health management.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The funding for this study was provided by Innovative Medical Devices Initiative (IMDI), LSHM21009. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.