American journal of preventive cardiology, Jun 1, 2021
Turkey, like many countries, is facing a growing burden of non-communicable disease (NCD)s and is... more Turkey, like many countries, is facing a growing burden of non-communicable disease (NCD)s and is among the countries with high cardiovascular mortality in Europe. Moreover, Turkey currently has the highest rate of premature cardiovascular disease (CVD) in Europe. During the last decades, Turkey made fundamental reforms in the health system to improve the treatment of risk factors to prevent CVD. The most outstanding success was in the area of tobacco control (13.4% decrease in smoking prevalence) and decreasing the salt consumption of the population (from 18 to 9.9 g/day) leading to a significant decrease in CVD mortality from 45% to 36.8% of all deaths. However, obesity and diabetes are increasing rapidly as a result of urbanization, low physical activity and unhealthy eating and the new generation is starting to take up smoking. The increase in cardiometabolic risk factors and aging of the population are expected to increase the number of CVD deaths. All CVD risk factors except smoking are significantly more prevalent in women. In addition, rare disease is a country specific problem with a significant contribution to the high rates of premature CVD in Turkey. Despite major improvements in management in acute coronary syndromes, sustained achievement in guideline recommended goals is suboptimal. In patients with a previous cardiovascular event smoking rate is 25.5%, 80.9% of these patients are overweight (BMI ≥25 kg/m2), 30% obese (BMI ≥30 kg/m2), and LDL‐cholesterol targets of 70 mg/dL are attained in only 18%. Herein, we scrutinize the achievements and challenges of Turkey in establishing a ‘National Heart Health Policy’ aiming to decrease the burden of CVD and its risk factors.
Background It is important to determine which anthropometric measurements are better predictor of... more Background It is important to determine which anthropometric measurements are better predictor of coronary heart disease risk in local settings. The aim of this study is to compare the predictive power of anthropometric indices including recent ones such as body shape index (ABSI) and waist to height ratio(WHtR) for risk of developing CHD and history of CHD. Methods We used cross-sectional data from nationally representative Chronic Diseases and Risk factors Survey conducted by Ministry of Health in 2011. Body mass index …
BACKGROUND The increasing population of senior citizens has led to a rise in the demand for healt... more BACKGROUND The increasing population of senior citizens has led to a rise in the demand for healthcare services, with chronic diseases being a major burden. Person-centered integrated care is required to address these challenges; hence, the Turkish Ministry of Health has initiated strategies to implement an integrated healthcare model for chronic disease management. OBJECTIVE We aim to present the design, implementation, and initial nationwide performance results of the national Disease Management Platform (DMP). The objective of this platform is to enable the implementation of an integrated health service model for chronic disease management in Turkey in a family physician-centered manner. It aims to ensure that national clinical treatment protocols that are designed based on evidence-based clinical guidelines are carried out effectively and easily followed with the help of decision support services. METHODS Disease Management Platform is an integrated care solution that heavily ut...
Objective: To inform strategies aimed at improving blood pressure (BP) control and reducing salt ... more Objective: To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician’s advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. Design: Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. Settings: Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). Participants: Nationally representat...
Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing ... more Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, ...
Background: Readmission to the hospital is one of the most important problems in chronic obstruct... more Background: Readmission to the hospital is one of the most important problems in chronic obstructive pulmonary disease (COPD) patients receiving long-term oxygen therapy (LTOT) and noninvasive ventilation (NIV). The aim of this trial is to find out whether a structured discharge and follow-up protocol reduce the rate of unplanned, COPD-related hospital readmissions over 90 days in patients receiving LTOT and/or NIV. Herein the results of the interim analysis are presented. Method: The study was planned as Turkish Thoracic Society and GARD-Turkey project and carried out 10 centers throughout Turkey. COPD patients who were prescribed LTOT and/or NIV were included and randomized to either intervention or control arm. The intervention mainly consisted of detailed training before discharge and close follow-up strategy. Control patients received usual care, which consisted of basic education of the patient about the therapies. Results: A total of 112 patients were included in the study within the first year and data analysis was performed in 65 patients (control group 26, intervention group 39) who finished the study period. It was observed that there was no difference between the study groups for subjective outcomes and the median duration of LTOT/NIV use. The hospital readmission and hospitalization rates were 30.7% and 11.5% in control group and 15.4% and 5.1% in the intervention group, respectively. Conclusion: The preliminary results showed that structured discharge and follow up protocol might be a helpful approach for prevention of recurrent admissions in COPD patients with chronic respiratory failure
Although chronic respiratory disorders are important causes of morbidity and mortality, health ca... more Although chronic respiratory disorders are important causes of morbidity and mortality, health care workers, patients and caretakers are not well informed about these disorders. Therefore these problems are underdiagnosed and undertreated; also preventive measures are not widely taken. Our aim was to evaluate the knowledge of asthma and chronic obstructive pulmonary disease (COPD) in Turkey. This study was designed and performed as a Global Alliance Against Respiratory Disorders (GARD) project. People greater than 15 years of age who lived in cities with a population of 200 or greater were eligible for the study. A questionnaire including demographic data and questions regarding asthma and COPD was used for the evalution of the participants. 12.000 people were selected (6000 in rural and 6000 in urban areas); 8527 people were reached. 8342 people who completed the questionnaire were included to the study. There were 4182 (50.1%) female and 4160 (%49.9) male subjects. 49.6% of the su...
Introduction: Although chronic respiratory disorders are important causes of morbidity and mortal... more Introduction: Although chronic respiratory disorders are important causes of morbidity and mortality, health care workers, patients and caretakers are not well informed about these disorders. Therefore these problems are underdiagnosed and undertreated; also preventive measures are not widely taken. Our aim was to evaluate the knowledge of asthma and chronic obstructive pulmonary disease (COPD) in Turkey. This study was designed and performed as a Global Alliance Against Respiratory Disorders (GARD) project. Materials and Methods: People greater than 15 years of age who lived in cities with a population of 200 or greater were eligible for the study. A questionnaire including demographic data and questions regarding asthma and COPD was used for the evalution of the participants. Results: 12.000 people were selected (6000 in rural and 6000 in urban areas); 8527 people were reached. 8342 people who completed the questionnaire were included to the study. There were 4182 (50.1%) female a...
American journal of preventive cardiology, Jun 1, 2021
Turkey, like many countries, is facing a growing burden of non-communicable disease (NCD)s and is... more Turkey, like many countries, is facing a growing burden of non-communicable disease (NCD)s and is among the countries with high cardiovascular mortality in Europe. Moreover, Turkey currently has the highest rate of premature cardiovascular disease (CVD) in Europe. During the last decades, Turkey made fundamental reforms in the health system to improve the treatment of risk factors to prevent CVD. The most outstanding success was in the area of tobacco control (13.4% decrease in smoking prevalence) and decreasing the salt consumption of the population (from 18 to 9.9 g/day) leading to a significant decrease in CVD mortality from 45% to 36.8% of all deaths. However, obesity and diabetes are increasing rapidly as a result of urbanization, low physical activity and unhealthy eating and the new generation is starting to take up smoking. The increase in cardiometabolic risk factors and aging of the population are expected to increase the number of CVD deaths. All CVD risk factors except smoking are significantly more prevalent in women. In addition, rare disease is a country specific problem with a significant contribution to the high rates of premature CVD in Turkey. Despite major improvements in management in acute coronary syndromes, sustained achievement in guideline recommended goals is suboptimal. In patients with a previous cardiovascular event smoking rate is 25.5%, 80.9% of these patients are overweight (BMI ≥25 kg/m2), 30% obese (BMI ≥30 kg/m2), and LDL‐cholesterol targets of 70 mg/dL are attained in only 18%. Herein, we scrutinize the achievements and challenges of Turkey in establishing a ‘National Heart Health Policy’ aiming to decrease the burden of CVD and its risk factors.
Background It is important to determine which anthropometric measurements are better predictor of... more Background It is important to determine which anthropometric measurements are better predictor of coronary heart disease risk in local settings. The aim of this study is to compare the predictive power of anthropometric indices including recent ones such as body shape index (ABSI) and waist to height ratio(WHtR) for risk of developing CHD and history of CHD. Methods We used cross-sectional data from nationally representative Chronic Diseases and Risk factors Survey conducted by Ministry of Health in 2011. Body mass index …
BACKGROUND The increasing population of senior citizens has led to a rise in the demand for healt... more BACKGROUND The increasing population of senior citizens has led to a rise in the demand for healthcare services, with chronic diseases being a major burden. Person-centered integrated care is required to address these challenges; hence, the Turkish Ministry of Health has initiated strategies to implement an integrated healthcare model for chronic disease management. OBJECTIVE We aim to present the design, implementation, and initial nationwide performance results of the national Disease Management Platform (DMP). The objective of this platform is to enable the implementation of an integrated health service model for chronic disease management in Turkey in a family physician-centered manner. It aims to ensure that national clinical treatment protocols that are designed based on evidence-based clinical guidelines are carried out effectively and easily followed with the help of decision support services. METHODS Disease Management Platform is an integrated care solution that heavily ut...
Objective: To inform strategies aimed at improving blood pressure (BP) control and reducing salt ... more Objective: To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician’s advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. Design: Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. Settings: Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). Participants: Nationally representat...
Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing ... more Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, ...
Background: Readmission to the hospital is one of the most important problems in chronic obstruct... more Background: Readmission to the hospital is one of the most important problems in chronic obstructive pulmonary disease (COPD) patients receiving long-term oxygen therapy (LTOT) and noninvasive ventilation (NIV). The aim of this trial is to find out whether a structured discharge and follow-up protocol reduce the rate of unplanned, COPD-related hospital readmissions over 90 days in patients receiving LTOT and/or NIV. Herein the results of the interim analysis are presented. Method: The study was planned as Turkish Thoracic Society and GARD-Turkey project and carried out 10 centers throughout Turkey. COPD patients who were prescribed LTOT and/or NIV were included and randomized to either intervention or control arm. The intervention mainly consisted of detailed training before discharge and close follow-up strategy. Control patients received usual care, which consisted of basic education of the patient about the therapies. Results: A total of 112 patients were included in the study within the first year and data analysis was performed in 65 patients (control group 26, intervention group 39) who finished the study period. It was observed that there was no difference between the study groups for subjective outcomes and the median duration of LTOT/NIV use. The hospital readmission and hospitalization rates were 30.7% and 11.5% in control group and 15.4% and 5.1% in the intervention group, respectively. Conclusion: The preliminary results showed that structured discharge and follow up protocol might be a helpful approach for prevention of recurrent admissions in COPD patients with chronic respiratory failure
Although chronic respiratory disorders are important causes of morbidity and mortality, health ca... more Although chronic respiratory disorders are important causes of morbidity and mortality, health care workers, patients and caretakers are not well informed about these disorders. Therefore these problems are underdiagnosed and undertreated; also preventive measures are not widely taken. Our aim was to evaluate the knowledge of asthma and chronic obstructive pulmonary disease (COPD) in Turkey. This study was designed and performed as a Global Alliance Against Respiratory Disorders (GARD) project. People greater than 15 years of age who lived in cities with a population of 200 or greater were eligible for the study. A questionnaire including demographic data and questions regarding asthma and COPD was used for the evalution of the participants. 12.000 people were selected (6000 in rural and 6000 in urban areas); 8527 people were reached. 8342 people who completed the questionnaire were included to the study. There were 4182 (50.1%) female and 4160 (%49.9) male subjects. 49.6% of the su...
Introduction: Although chronic respiratory disorders are important causes of morbidity and mortal... more Introduction: Although chronic respiratory disorders are important causes of morbidity and mortality, health care workers, patients and caretakers are not well informed about these disorders. Therefore these problems are underdiagnosed and undertreated; also preventive measures are not widely taken. Our aim was to evaluate the knowledge of asthma and chronic obstructive pulmonary disease (COPD) in Turkey. This study was designed and performed as a Global Alliance Against Respiratory Disorders (GARD) project. Materials and Methods: People greater than 15 years of age who lived in cities with a population of 200 or greater were eligible for the study. A questionnaire including demographic data and questions regarding asthma and COPD was used for the evalution of the participants. Results: 12.000 people were selected (6000 in rural and 6000 in urban areas); 8527 people were reached. 8342 people who completed the questionnaire were included to the study. There were 4182 (50.1%) female a...
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