Conclusions Interventions using physician reminders , using dedicated personnel to deliver screening , and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake
Background Cardiovascular disease ( CVD ) is the leading cause of death globally .
However , many individuals are unaware of their CVD risk factors .
The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of  CVD risk factors screening .
A real-world stepped wedge cluster randomized trial of practice facilitation to improve cardiovascular care
Background Practice facilitation has been associated with meaningful improvements in disease prevention and quality of patient care . Using practice facilitation , the Improved Delivery of Cardiovascular Care ( IDOCC ) project aim ed to improve the delivery of evidence -based cardiovascular care in primary care practice s across a large health region . Our goal was to evaluate IDOCC ’s impact on adherence to processes of care delivery . Methods A pragmatic stepped wedge cluster r and omized trial recruiting primary care providers in practice s located in Eastern Ontario , Canada ( Clinical Trials.gov : NCT00574808 ) . Participants were r and omly assigned by region to one of three steps . Practice facilitators were intended to visit practice s every 3–4 ( year 1—intensive ) or 6–12 weeks ( year 2—sustainability ) to support changes in practice behavior . The primary outcome was mean adherence to indicators of evidence -based care measured at the patient level . Adherence was assessed by chart review of a r and omly selected cohort of 66 patients per practice in each pre-intervention year , as well as in year 1 and year 2 post-intervention . Results Eighty-four practice s ( 182 physicians ) participated . On average , facilitators had 6.6 ( min : 2 , max : 11 ) face-to-face visits with practice s in year 1 and 2.5 ( min : 0 max : 10 ) visits in year 2 . We collected chart data from 5292 patients . After adjustment for patient and provider characteristics , there was a 1.9 % ( 95 % confidence interval ( CI ) : −2.9 to −0.9 % ) and 4.2 % ( 95 % CI : −5.7 to −2.6 % ) absolute decrease in mean adherence from baseline to intensive and sustainability years , respectively . Conclusions IDOCC did not improve adherence to best- practice guidelines . Our results showed a small statistically significant decrease in mean adherence of question able clinical significance . Potential reasons for this result include implementation challenges , competing priorities in practice s , a broad focus on multiple chronic disease indicators , and use of an overall index of adherence . These results contrast with findings from previously reported facilitation trials and highlight the complexities and challenges of translating research findings into clinical practice .Trial registration Clinical Trials.gov
Conclusions Interventions using physician reminders , using dedicated personnel to deliver screening , and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake
Background Cardiovascular disease ( CVD ) is the leading cause of death globally .
However , many individuals are unaware of their CVD risk factors .
The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of  CVD risk factors screening .