| Objective: To understand the risk factors control status of atherosclerotic cardiovascular diseases(ASCVD)high-risk groups signed by family physician,and analyze the possible factors affecting the level of blood pressure,blood lipids and bloodglucose of the population.To provide baseline data to further improve the risk factor control rate of the elderly population at high risk of ASCVD,and explore specific measures to optimize the current contract service mode of family physician.Methods: A community health service center was selected from a general practice residential training base in each city of Liaoning Province,including Shenyang in central Liaoning,Dandong in eastern Liaoning,Chaoyang in western Liaoning,Dalian in southern Liaoning,and Fushun in northern Liaoning.Elderly ASCVD high-risk individuals who have been contracted by family doctors for more than 1 year in community health service centers were selected as research subjects,and the sample size was calculated using cluster sampling method,Sort according to the order of physical examination and randomly select.This study follows the principle of voluntary participation,and based on the inclusion and exclusion criteria,a total of 299 people were included as the research subjects.By combining the collection of residents’ health records with a questionnaire survey,basic information,lifestyle,cardiovascular disease related medical history,medication history,risk factor control level,positivity,medication compliance,and other data of patients were obtained.The overall risk factor comprehensive control rate and other indicators were analyzed.Results: 1.This study selected the elderly ASCVD high-risk groups from the contracted family doctors in five cities of Liaoning Province,and the screening rate of ASCVD highrisk groups was 53.21%,55.12% in Shenyang,56.86% in Dandong,46.40% in Dalian and50.78% in Chaoyang.According to the inclusion and exclusion criteria,a total of 299 elderly people were included,with an age range of 65-91 years and an average age of72.81±6.28 years.Among them,187 men(62.54%)and 112 women(37.46%).2.Prevalence of chronic diseases: 165(55.18%)were overweight and obese,and 134(44.82%)were not overweight.The prevalence rates of hypertension,diabetes and dyslipidemia were 77.92%,59.87% and 69.90% respectively.3.The control rate of hypertension group was 69.96%;The rate of reaching the standard of fasting blood glucose control in diabetes group was 50.28%;Among 169 patients diagnosed with dyslipidemia and with low density lipoprotein index,the control rate of low density lipoprotein was35.50%,the comprehensive control rate is 25.21%.4.In the current situation of whether the average monthly medical expenses exceed the monthly disposable income,the comprehensive control of the overspended population may be-1.013 times that of the nonoverspended population(95% CI: 0.146～0.906,P=0.030);Compared with those who do not exercise or rarely,the comprehensive control of people who exercise regularly and daily can be 0.888 times higher(95% CI: 1.006～5.870,P=0.049);The degree of enthusiasm is positively correlated with the comprehensive control of blood lipids,blood pressure and blood glucose,and the correlation coefficient is 0.250(95% CI: 1.193～1.383,P<0.001).Conclusion: The detection rate of ASCVD high-risk population in the elderly population of Liaoning Province is relatively high in this study;The control rate of hypertension,diabetes and dyslipidemia in the elderly ASCVD high-risk group who signed a family contract were significantly higher,but the comprehensive control rate was not ideal;Medical cost overruns,exercise and motivation are related to comprehensive patient control.It is recommended that family doctors continue to do a good job in people-centered chronic disease management,further improve the control rate of major risk factors for ASCVD,do a good job in primary prevention of ASCVD,and improve the quality of life of the elderly. |
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