Risk factors and prevention for CVD and management in primary care settings TUTORIAL

Question 1

Describe five levels of prevention using CVDs and renal disease as case studies

Answer 1

The five levels of prevention include:
- primordial: relates to policy, applies at population level
- examples include: health system changes, taxes, green spaces, outdoor gyms, improved food security and options, advertising changes (no tobacco
- primary: aims at suscpetibile but healthy individuals
- examples of individual: GP education e.g. SNAPO, adherence to meds that constitute RF: diabetes
- population level: school in SES area education, screening, awareness campaigns and social media advertising
- secondary: aimed at asymptomatic individuals, early detection
- individuals: screening, opportunistic; targeted education
- population: screening, organised population program; national guidelines
- tertiary- aim to reduce disability from disease
- individual: checks on management, drug adherence, rehab post-event, diet, counselling
- population: family/peer/HF assistance
- quaternary: not specific to individual or population. Encompassess harm minimisation: e.g.s continuity of care, patient centred cate, deprescribign

Question 2

Identify individual and social determinants of CVDs and/or renal disease

Answer 2

Individual:
aka proximal
Can be divided into behavioural and biomedical
Non-mods: sex, age, family history
Biomedical:
- hypertension, diabetes
- family history
- AKI
- CKD: skin infections, anxiety, depression, dehydation, diet, alchol, polltuon

Distal:
- SES
- culture

CKD: employment, poverty, inequity,economic instability, social networks and realtionships, food insecurity, water pollution, fargmented health cate and services, culture and health seeking behaviours, housing, roads and green spaces

Question 3

Design management plan and prevention strategies for patient with NCDs (e.g. CVDs or renal disease)

Answer 3

• integrated approach: clear mass media adveritsing with clear call to actio
• PH initiatives that reduce exposure to proximals, and screens that target patinet groups
• house
• water’
• food insecurity; alc sugar tobaccot axes
• health education and intervatnion in PCP setting s(GP or otherwise_
• strengthen primary and secondary healthcate

Question 4

Describe potential limitation of prevention strategies targeting only individual risk factors and discuss the need for structural intervention to prevent NCDs

Answer 4

• no targeting of distal determinants

interacts with proximal, creates vicious cycle
- doesnt address: so problem is not solved
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