Cargando…

Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine

BACKGROUND: Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in preven...

Descripción completa

Detalles Bibliográficos
Autores principales: Laatikainen, Tiina, Dumcheva, Anastasiya, Kiriazova, Tetiana, Zeziulin, Oleksandr, Inglin, Laura, Collins, Dylan, Farrington, Jill
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839221/
https://www.ncbi.nlm.nih.gov/pubmed/33499868
http://dx.doi.org/10.1186/s12913-021-06068-1
_version_ 1783643351753424896
author Laatikainen, Tiina
Dumcheva, Anastasiya
Kiriazova, Tetiana
Zeziulin, Oleksandr
Inglin, Laura
Collins, Dylan
Farrington, Jill
author_facet Laatikainen, Tiina
Dumcheva, Anastasiya
Kiriazova, Tetiana
Zeziulin, Oleksandr
Inglin, Laura
Collins, Dylan
Farrington, Jill
author_sort Laatikainen, Tiina
collection PubMed
description BACKGROUND: Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care. METHODS: A mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed. RESULTS: The capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice. CONCLUSIONS: A large scale capacity building intervention improved primary health care professionals’ knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06068-1.
format Online
Article
Text
id pubmed-7839221
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-78392212021-01-27 Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine Laatikainen, Tiina Dumcheva, Anastasiya Kiriazova, Tetiana Zeziulin, Oleksandr Inglin, Laura Collins, Dylan Farrington, Jill BMC Health Serv Res Research Article BACKGROUND: Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care. METHODS: A mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed. RESULTS: The capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice. CONCLUSIONS: A large scale capacity building intervention improved primary health care professionals’ knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06068-1. BioMed Central 2021-01-27 /pmc/articles/PMC7839221/ /pubmed/33499868 http://dx.doi.org/10.1186/s12913-021-06068-1 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Laatikainen, Tiina
Dumcheva, Anastasiya
Kiriazova, Tetiana
Zeziulin, Oleksandr
Inglin, Laura
Collins, Dylan
Farrington, Jill
Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title_full Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title_fullStr Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title_full_unstemmed Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title_short Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine
title_sort capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from ukraine
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839221/
https://www.ncbi.nlm.nih.gov/pubmed/33499868
http://dx.doi.org/10.1186/s12913-021-06068-1
work_keys_str_mv AT laatikainentiina capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT dumchevaanastasiya capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT kiriazovatetiana capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT zeziulinoleksandr capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT inglinlaura capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT collinsdylan capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine
AT farringtonjill capacitybuildingofhealthcareprofessionalstoperforminterprofessionalmanagementofnoncommunicablediseasesinprimarycareexperiencesfromukraine