Učinak programirane intervencije liječnika obiteljske medicine na stavove pacijenata prema preventivnim aktivnostima i na čimbenike rizika za cerebrovaskularne bolesti [The effects of the programmed intervention of familly medicine doctors on the patients' attitudes towards preventive activities and the risk factors for cerebbrovascular diseases]

The aim of the research was to examine the changes in attitudes and behaviors of the patients after the systematic and planned intervention pf the family medicine doctors and efficiency in prevention of risk factors in cerebrovascular diseases in person of 40 years of age and older under the care of family medicine doctors. The research was conducted as a part of the project called “The effectiveness of the family medicine doctors in prevention of cardiovascular diseases” (Cardiovascular risk and intervention study in Croatia – family medicine – CRISIC – fm) which was included in the international database of the randomized control studies (ISRCTN31857696). The first phase of the research (cross–sectional) included 59 doctors randomized in intervention and control groups. The subjects of the intervention group underwent the systematized and programmed intervention while the control group continued with the usual care. All the subjects in both groups were prospectively monitored and 24 months after the initial visit were retested using identical methods to ascertain the outcome of intervention in both groups. The CRISTIC – fm study initially included 2485 subjects (946 males and 1537 females) with the average age of 61 (±10.8). The intervention group changed most of its attitudes stating that not smoking, cholesterol level, blood glucose, artery blood pressure, Pap–tests and mammography were very important holding the statistic significance level of P<0,001. The assessment of diet relevance as well as adequate alcohol assumption was changed for the better with the statistic significance level of P=0,01. The assessment of relevance of physical activity was changed to the borderline level of the statistic significance level (P=0,05). Previously mentioned changes in attitude followed the aimed changes in systolic and diastolic blood pressures, WHR, total cholesterol level, LDL – cholesterol, blood glucose while starving, triglyceride and HDL cholesterol. The results of our research showed that with programmed systematic approach of family medicine doctors the patients change their attitudes regarding the importance of certain modes of behavior and also change their habits and behavior. Those changes can be objectified by changes in measurable parameters. Previously mentioned changes in behavior did not result in changes regarding the quality of life neither did they have influence on total risk for stroke measured by current assessment tables.