What should selective cardiometabolic prevention programmes in European primary care look like? A consensus-based design by the SPIMEU group

Eur J Gen Pract. 2019 Jul;25(3):101-108. doi: 10.1080/13814788.2019.1641195. Epub 2019 Aug 14.

Abstract

Background: Selective prevention of cardiometabolic diseases (CMD)-that is, preventive measures specifically targeting the high-risk population-may represent the most effective approach for mitigating rising CMD rates. Objectives: To develop a universal concept of selective CMD prevention that can guide implementation within European primary care. Methods: Initially, 32 statements covering different aspects of selective CMD prevention programmes were identified based on a synthesis of evidence from two systematic literature reviews and surveys conducted within the SPIMEU project. The Rand/UCLA appropriateness method (RAM) was used to find consensus on these statements among an international panel consisting of 14 experts. Before the consensus meeting, statements were rated by the experts in a first round. In the next step, during a face-to-face meeting, experts were provided with the results of the first rating and were then invited to discuss and rescore the statements in a second round. Results: In the outcome of the RAM procedure, 28 of 31 statements were considered appropriate and three were rated uncertain. The panel deleted one statement. Selective CMD prevention was considered an effective approach for preventing CMD and a proactive approach was regarded as more effective compared to case-finding alone. The most efficient method to implement selective CMD prevention systematically in primary care relies on a stepwise approach: initial risk assessment followed by interventions if indicated. Conclusion: The final set of statements represents the key characteristics of selective CMD prevention and can serve as a guide for implementing selective prevention actions in European primary care.

Keywords: Selective prevention; cardiometabolic disease; consensus development; general practice; primary care.

MeSH terms

  • Cardiovascular Diseases / prevention & control*
  • Consensus
  • Delivery of Health Care / organization & administration
  • Europe
  • Humans
  • Metabolic Diseases / prevention & control*
  • Preventive Health Services / organization & administration*
  • Primary Health Care / organization & administration*
  • Risk Assessment / methods
  • Risk Factors

Grants and funding

The manuscript is part of the project/joint ‘663309/SPIM EU’ which has received funding from the European Union’s Health Programme (2014–2020).