Lipid Management in Primary Care for Socioeconomically Disadvantaged Populations in Northern England: A Qualitative Study.

IF 3 Q1 PRIMARY HEALTH CARE
Yu Fu, Sarah Sewdon, Julia L Newton
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Abstract

Introduction: People in low socioeconomic circumstances are more susceptible to dyslipidemia and cardiovascular disease than those living in more affluent populations. Limited healthcare access and low preventive care uptake widen health inequalities. Understanding how primary care can better serve socioeconomically disadvantaged communities is urgently needed.

Aim: To explore lipid management delivery in socioeconomically disadvantaged areas and identify barriers and enablers for lipid optimization for socioeconomically disadvantaged populations.

Method: Individual semi-structured remote interviews with clinicians, purposively recruited from primary care practices serving extremely socioeconomically disadvantaged communities in Northern England, UK, who were involved in the delivery and organization of lipid management. Interviews were recorded, transcribed, and analyzed thematically following framework analysis.

Results: Fifteen interviews were undertaken. Five themes emerged: complex and multimorbid patients with competing priorities, limited access and follow-up to supporting services, being flexible and working beyond guidelines, high workload with inadequate staff support, and the need for care integrity and sustainable support.

Conclusion: The findings of this study have been fed back to the delivery of the national program to improve cardiovascular health. Socioeconomically disadvantaged communities have complex health needs posing risks of multimorbidity but living with low health literacy, competing demands upon time, and financial constraints. Clinicians are willing to adapt services but a lack of guidance for care and funded services remains a significant barrier to targeted service delivery. Research is needed to inform the effectiveness and acceptability of interventions for lipid management tailored for those experiencing low socioeconomic disadvantage.

英格兰北部社会经济处境不利人群初级保健中的血脂管理:定性研究。
导言:与生活在富裕地区的人相比,社会经济地位低下的人更容易患血脂异常和心血管疾病。有限的医疗途径和较低的预防性保健接受率扩大了健康不平等。目的:探讨在社会经济条件较差的地区提供血脂管理服务的情况,并确定社会经济条件较差人群血脂优化的障碍和促进因素:方法:对参与血脂管理实施和组织的临床医生进行个人半结构化远程访谈,访谈对象有针对性地从英国英格兰北部社会经济条件极差社区的初级保健实践中招募。对访谈进行了记录、转录,并根据框架分析进行了专题分析:结果:共进行了 15 次访谈。结果:共进行了 15 次访谈,出现了五个主题:复杂和多病的患者,其优先事项相互竞争;获得支持服务的途径和后续服务有限;工作灵活,超出指南要求;工作量大,员工支持不足;需要完整的护理和可持续的支持:这项研究的结果已反馈到改善心血管健康的国家计划的实施中。社会经济条件较差的社区有着复杂的健康需求,可能会造成多病共存的风险,但他们的健康知识水平较低、时间需求量大且经济拮据。临床医生愿意调整服务,但缺乏护理指导和资助服务仍然是提供有针对性服务的重大障碍。需要开展研究,以了解为社会经济地位低下者量身定制的血脂管理干预措施的有效性和可接受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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