Screening and primary prevention of cardiovascular diseases: implementation of dedicated general practitioners visits for the 50-years-old population in Luxembourg
Authors: Louyot M , Dossa D , Ruiz-Castell M , Mouche F , Beissel J , Couffignal S 
Published: June 2024

Abstract

Background
As part of the European YOUNG50 project, Luxembourg implemented a national adaptation of the project in 2022. This served as a pilot study evaluating the feasibility of implementing a screening and prevention program for cardiovascular diseases risk factors (CVDRF) through general practitioners (GPs) in Luxembourg.

Purpose
The study aimed to actively assess and prevent CVDRF in patients aged 50 without cardiometabolic medical history, through a series of screening and prevention GP visits.

Methods
We designed a 6-months quasi-experimental before-after study. GPs participated on a voluntary basis. They were trained in using the study online tools and adhered to the study’s objectives. They selected eligible participants from their patient records: individuals aged 50 with no prior cardiometabolic medical history, oncological pathologies or chronic renal failure. Participants CVDRF were evaluated through an online self-administered questionnaire on lifestyle habits, as well as through clinical and biological data. Nine CVDRF were explored: smoking, physical activity, alcohol, fruit and vegetable consumption, BMI, waist circumference, blood pressure, glycaemia and total cholesterolemia. GPs provided personalized advice to participants at risk. They jointly selected a specific objective to focus on until the follow-up visit. A satisfaction survey has been performed for participants and GPs.

Results
15 GPs showed interest in the program and completed the training, 9 of them recruited participants. Out of 71 invited participants, 55 answered the online questionnaire and 47 (66%) attended the GP visit. More than 80% of the participants had 2 or more risk factors. The most frequent risk factors were eating ≤2 portions of fruits or vegetables/day (66.0%), BMI≥25 kg/m² (55.3%) and less than 150 min of physical activity/week (48.9%). 39 (82.3%) participants were invited to the follow-up visit and 35 (89.7%) attended. 23 (65.7%) participants reached their initial objective. All CVDRF were assessed in 31 participants and 12 of them (38.7%) showed a reduction in their cumulative number of risk factors. 43% of participants completed the satisfaction questionnaire for the initial visit and all of them would recommend this program. 89% of GPs participated in the satisfaction interview. They appreciated the dedicated prevention consultation, but they regretted the too restricted selection criteria and the choice of biologic data (cut-off, absence of LDL-cholesterol). However, all of them would recommend this program to a colleague.

Conclusion
This screening and prevention program involving GPs is promising in terms of participation, retention and satisfaction rates. Therefore, Luxembourg confirmed its interest by including it in the national cardio-neuro-vascular plan. In order to reach more participants in the population, YOUNG50 will be adapted with alternative recruitment approaches and an extension of the inclusion ages to younger participants.