Innovations in public health

Health minister Lord Darzi endorsed MyAction as an example of a community-based scheme that is ideally designed to tackle the government’s public health targets of heart disease and stroke when he launched the Westminster programme in January.
He said: ‘Heart disease and stroke is the main factor in the health inequalities that exist between rich and poor, not only in Westminster with its diverse population, but across the UK.

‘This innovative programme has the potential to make a significant impact as GPs, cardiologists, nurses and physiotherapists work together to bring services into the community that are easier to access for this group of patients.’ Bridget Hurley, CSP professional adviser and lead for Move for Health, the CSP’s initiative to promote physiotherapists’ role as enablers of physical activity, agrees that MyAction is well aligned with the Society’s own work to promote physiotherapy’s role in public health. She says: ‘MyAction, an evidence-based initiative, provides an innovative, integrated approach to the delivery of preventative health. This type of initiative is precisely what Lord Darzi hails as the way forward for the NHS in his Next Stage Review. ‘All health professionals have a significant role to play in promoting good health and this programme captialises on the skills and expertise a multidisciplinary team can bring to primary and secondary prevention approaches. ‘Physiotherapists play a critical role in the delivery of this service as enablers of physical activity. Move for Health, strongly supports MyAction and recognises the significant challenge people face in adhering to exercise (programmes), especially for those with chronic disease or risk factors for poor health. ‘This programme is just one of the many examples of how physiotherapists are utilising their expertise in physical activity to promote healthy lifestyles.’

What’s the evidence?

Euroaction study aim: to investigate whether a nurse coordinated multidisciplinary, family-based preventive cardiology programme could improve standards in routine clinical practice The study took place in hospitals and primary care centres in France, Italy, Poland, Spain, the Netherlands, Denmark, Sweden and the UK, where 3,088 patients with coronary disease and 2,318 at high risk were randomly assigned intervention or usual care. The primary endpoints, measured at one year, included family-based lifestyle change and management of blood pressure, lipids and blood glucose to target concentrations.The researchers concluded: ‘The Euroaction preventive cardiology programme reduced the risk of cardiovascular disease compared with usual care mainly through lifestyle changes by families, who together made healthier lifestyle choices and became more physically active than before.’

FURTHER INFO

Wood et al, ‘Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial’, Lancet (2008), 371:1999 www.escardio.org/euroaction

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