Cardiovascular disease prevention

Public Health England’s Action plan for cardiovascular disease prevention, 2017 to 2018 has been launched on World Heart Day (29 Sept).

With cardiovascular disease (CVD) causing 26% of all deaths and costing the UK healthcare system over £8 billion a year, it is felt more can be done to prevent many thousands of avoidable deaths and ill health. As well as highlighting some of PHE’s programmes and resources, the plan includes some  CVD initiatives planned for 2017 /18.

This includes work looking at a new return on investment tool, air pollution, sugar reduction and the NHS Health Check programmes. The plan is aimed at those involved in the commissioning and provision of services for CVD and its prevention such as clinicians, local authorities, service commissioners, public health specialists, the third sector and PHE staff.

The action plan can be downloaded here

Campaign materials for World Heart Day can be downloaded here

 

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NICE recommends ‘lifestyle tips’ for 1.7m at risk of type 2 diabetes

People at the highest risk of type 2 diabetes should be given intensive exercise and weight loss help by the NHS, NICE has recommended.

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Healthcare professionals, from GPs to community nurses and pharmacists, should refer people with elevated blood sugars to exercise classes and nutrition courses, NICE has said in updated guidance.  Lifestyle-change programmes, such as NHS England and Public Health England (PHE)’s ‘Healthier You: NHS Diabetes Prevention Programme’, provide personalised help for patients to change their diet and increase their physical activity.

NICE has identified 1.7 million people as having the highest risk of developing type 2 diabetes, and  recommends that GPs should see specific groups of patients for a diabetes risk assessment.

Full guidance: Type 2 diabetes: prevention in people at high risk

Effectiveness of dementia risk reduction messaging in NHS health checks.

NHS health check 40-64 dementia pilot research findings | Alzheimer’s Society

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The NHS Health Check programme is a statutory public health intervention commissioned by all local authorities in England. It aims to improve the health and wellbeing of adults aged 40-74 years through the promotion of earlier awareness, assessment, and management of the major risks factors and conditions driving premature death, disability and health inequalities in England.

The overall aim of the research was to evaluate the pilot and assess the feasibility of extending the NHS Health Check for 40-64 year olds to include a dementia risk reduction component. Specific objectives of the research included first, to understand the impact of the NHS Health Check on an individual’s knowledge and awareness of dementia risk reduction and the impact of the intervention on individuals’ intention to change behaviour.

The second objective was to identify (where sample sizes allowed) whether any differences in the delivery of the intervention between pilot sites had any effect on individual’s awareness and understanding of dementia risk reduction.

The third objective was to understand professional awareness and confidence in promoting dementia risk reduction messages and to identify further training requirements, resources and support.

The final objective was to assess any implications for services and commissioners and provide PHE with advice on any further longer-term evaluation that will be required.

Full report here

Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

Interventions to prevent cognitive decline & dementia

Evidence supporting three interventions that might slow cognitive decline and the onset of dementia is encouraging but insufficient to justify a public health campaign focused on their adoption | ScienceDaily

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Image source: NASEM

Cognitive training, blood pressure management for people with hypertension, and increased physical activity all show modest but inconclusive evidence that they can help prevent cognitive decline and dementia, but there is insufficient evidence to support a public health campaign encouraging their adoption, says a new report from the National Academies of Sciences, Engineering, and Medicine.  Additional research is needed to further understand and gain confidence in their effectiveness, said the committee that conducted the study and wrote the report.

Why is Hearing Loss a Public Health Concern?

Tremblay, K. L. (2017) Hearing Journal. 70(4) pp. 14,16

‘Answer: Because hearing loss is highly prevalent, with numerous associated health risks that burden affected individuals, their family, and their community.’

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When hearing loss is viewed from a public health perspective, the mission expands to include improving health and quality of life, not only through prevention and treatment of hearing loss but also through the promotion of healthy behaviors. An essential component of public health is the “collective action for sustained population-wide health improvement” (Lancet. 2004;363[9426]:2084 http://bit.ly/2lALIIj; Bull World Health Organ. 2014;92[5]:367 http://bit.ly/2lAFqIq). As such, there are many ongoing initiatives aimed at making hearing health care more accessible and affordable within and outside of the medical model (Ear Hear. 2016;37[4]:376 http://bit.ly/2lAL6SW; Ear Hear. 2010;31[1]:2 http://bit.ly/2lAIMew).

Read the full article here

Insufficient evidence to support depression prevention programmes

Cristea, I. The Mental Elf Blog. Published online: 21 February 2017

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Research on prevention differentiates between universal interventions, which are implemented for a designated population regardless of the risk (e.g., all school-age children) and targeted interventions, which are aimed at a population at high risk for a disorder. Recent large trials in adults covered on the Mental Elf showed prevention of depression is particularly effective when it is targeted.

In a recent Cochrane systematic review, Hetrick and colleagues examined whether three evidence-based psychological interventions (cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and ‘third wave’ CBT) are effective in preventing the onset of depressive disorder in children and adolescents.

Read the full overview here

Read the original research article here