Effectiveness of a prevention program in the incidence of cardiovascular outcomes in a low-income population from Colomb
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(2020) 20:1416
RESEARCH ARTICLE
Open Access
Effectiveness of a prevention program in the incidence of cardiovascular outcomes in a low-income population from Colombia: a real-world propensity score-matched cohort study Pablo Miranda-Machado1,2* , Fernando Salcedo-Mejía1,2, Devian Parra-Padilla1,2, Rusvelt Vargas-Moranth1,2, Nelson Rafael Alvis-Zakzuk1, Justo Paz-Wilches3, Juan Fernández-Mercado3, Fernando De la-Hoz Restrepo2,4 and Nelson Alvis-Guzmán1,2
Abstract Background: Cardiovascular diseases (CVDs) and diabetes mellitus (DM) are among the leading cause of morbidity and mortality in low-and-middle-income countries (LMICs) but evidence in these contexts regarding the effectiveness of primary prevention interventions taking into account patient adherence is scarce. We aimed to evaluate the effectiveness of a cardiovascular risk management program (De Todo Corazón - DTC program) in the incidence of the first cardiovascular outcome (CVO) in a low-income population from the Caribbean region of Colombia using adherence as the main variable of exposure. Methods: A retrospective propensity score-matched cohort study was conducted. Adult patients with a diagnosis of hypertension (HTA), diabetes mellitus (DM), chronic kidney disease (CKD), or dyslipidemia affiliated to the DTC program between 2013 and 2018 were considered as the study population. Patients with 30 to 76 years, without a history of CVOs, and with more than 6 months of exposure to the program were included. The main outcome of interest was the reduction in the risk of CVOs (stroke, myocardial infarction, or congestive heart failure) based on the adherence to the intervention (attendance to medical appointments with health care professionals and the control of cardiovascular risk factors). Kaplan Meier curves and propensity score-matched Cox regression models were used to evaluate the association between adherence and the incidence of CVOs. (Continued on next page)
* Correspondence: [email protected] 1 ALZAK Foundation, Crespo St 67 #5-44 Cartagena, Colombia 2 Health Economics Research Group, University of Cartagena, Cartagena, Colombia Full list of author information is available at the end of the article
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