School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Public Health. 2023 Sep 22;11:1098312. doi: 10.3389/fpubh.2023.1098312. eCollection 2023.
The IraPEN program is an adapted version of the WHO-PEN program designed to prevent four major non-communicable diseases in Iran. This study aimed to determine the rate of compliance and related factors among individuals participating in the IraPEN program for the prevention of cardiovascular disease.
In this study, compliance was defined as timely referral to the health center as scheduled, and the researchers approached four pilot sites of IraPEN from March 2016 to March 2018. Sex-stratified logistic regressions were applied to investigate factors related to compliance. However, it is important to note that in this study, compliance was defined as compliance to revisit, not compliance to taking prescribed medications or behavioral lifestyle changes.
The total compliance rate, including timely compliance and early and late compliance, was 16.5% in men and 23.3% in women. The study found that cardiovascular risk factors such as diabetes, hypertension, hypercholesterolemia, and being underweight were associated with lower compliance. The higher calculated risk of CVD was associated with higher compliance, but after adjusting for cardiovascular risk factors, high-risk individuals showed lower compliance. There was negligible interaction between sex and other factors for compliance.
The compliance rate with scheduled programs for cardiovascular preventive strategies was very low, and high-risk individuals were less compliant, regardless of their high level of risk factors. The study recommends further training to increase awareness and knowledge regarding the IraPEN program and the prevention of non-communicable diseases among high-risk populations.
IraPEN 计划是世界卫生组织 PEN 计划的改编版,旨在预防伊朗的四种主要非传染性疾病。本研究旨在确定参与 IraPEN 计划预防心血管疾病的个体的依从率及其相关因素。
本研究将依从性定义为按时按计划转诊至健康中心,研究人员于 2016 年 3 月至 2018 年 3 月期间对 IraPEN 的四个试点进行了调查。应用性别分层逻辑回归分析了与依从性相关的因素。然而,需要注意的是,在本研究中,依从性被定义为按时复诊的依从性,而不是遵医嘱服药或改变行为生活方式的依从性。
男性的总依从率(包括按时、提前和延迟)为 16.5%,女性为 23.3%。研究发现,糖尿病、高血压、高胆固醇血症和体重过轻等心血管危险因素与依从性降低有关。计算出的 CVD 风险越高,依从性越高,但在调整了心血管危险因素后,高风险个体的依从性较低。性别与其他因素之间的交互作用可以忽略不计。
心血管预防策略的计划依从率非常低,无论风险因素水平如何,高风险个体的依从性都较低。研究建议进一步培训,以提高高危人群对 IraPEN 计划和非传染性疾病预防的认识和知识。