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American Journal of Respiratory Cell... May 2014
Topics: Chronic Disease; Humans; Lung Diseases; Primary Prevention
PubMed: 24783954
DOI: 10.1165/rcmb.2014-0071ED -
Pediatrics Sep 2020An updated synthesis of research on substance abuse prevention programs can promote enhanced uptake of programs with proven effectiveness, particularly when paired with...
CONTEXT
An updated synthesis of research on substance abuse prevention programs can promote enhanced uptake of programs with proven effectiveness, particularly when paired with information relevant to practitioners and policy makers.
OBJECTIVE
To assess the strength of the scientific evidence for psychoactive substance abuse prevention programs for school-aged children and youth.
DATA SOURCES
A systematic review was conducted of studies published up until March 31, 2020.
STUDY SELECTION
Articles on substance abuse prevention programs for school-aged children and youth were independently screened and included if they met eligibility criteria: (1) the program was designed for a general population of children and youth (ie, not designed for particular target groups), (2) the program was delivered to a general population, (3) the program only targeted children and youth, and (4) the study included a control group.
DATA EXTRACTION
Two reviewers independently evaluated study quality and extracted outcome data.
RESULTS
Ninety studies met eligibility criteria, representing 16 programs. Programs evaluated with the largest combined sample sizes were Drug Abuse Resistance Education, Project Adolescent Learning Experiences Resistance Training, Life Skills Training (LST), the Adolescent Alcohol Prevention Trial, and Project Choice.
LIMITATIONS
Given the heterogeneity of outcomes measured in the included studies, it was not possible to conduct a statistical meta-analysis of program effectiveness.
CONCLUSIONS
The most research has been conducted on the LST program. However, as with other programs included in this review, studies of LST effectiveness varied in quality. With this review, we provide an updated summary of evidence for primary prevention program effectiveness.
Topics: Adolescent; Child; Humans; Primary Prevention; Program Evaluation; Substance-Related Disorders
PubMed: 32769198
DOI: 10.1542/peds.2019-2747 -
Journal of Clinical Epidemiology Nov 2021Recommendations for preventing cardiovascular (CV) disease are currently separated into primary and secondary prevention. We hypothesize that relative effects of... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
Recommendations for preventing cardiovascular (CV) disease are currently separated into primary and secondary prevention. We hypothesize that relative effects of interventions for CV prevention are not different across primary and secondary prevention cohorts. Our aim was to test for differences in relative effects on CV events in common preventive CV interventions across primary and secondary prevention cohorts.
METHODS AND RESULTS
A systematic search was performed to identify individual patient data (IPD) meta-analyses that included both primary and secondary prevention populations. Eligibility assessment, data extraction, and risk of bias assessment were conducted independently and in duplicate. We extracted relative risks (RR) with 95% confidence intervals (95% CI) of the interventions over patient-important outcomes and estimated the ratio of RR for primary and secondary prevention populations. We identified five eligible IPDs representing 524,570 participants. Quality assessment resulted in overall low-to-moderate methodological quality. We found no subgroup effect across prevention categories in any of the outcomes assessed.
CONCLUSION
In the absence of significant treatment-subgroup interactions between primary and secondary CV prevention cohorts for common preventive interventions, clinical practice guidelines could offer recommendations tailored to individual estimates of CV risk without regard to membership to primary and secondary prevention cohorts. This would require the development of reliable ASCVD risk estimators that apply across both cohorts.
Topics: Cardiovascular Diseases; Humans; Practice Guidelines as Topic; Primary Prevention; Secondary Prevention
PubMed: 34400257
DOI: 10.1016/j.jclinepi.2021.08.006 -
American Journal of Cardiovascular... Apr 2015While evidence in support of aspirin use in secondary prevention is well documented, the role of aspirin in primary prevention remains unclear. We conducted a systematic... (Review)
Review
BACKGROUND AND OBJECTIVES
While evidence in support of aspirin use in secondary prevention is well documented, the role of aspirin in primary prevention remains unclear. We conducted a systematic literature review to evaluate aspirin use in cardiovascular disease (CVD) and cancer primary prevention, and consider whether aspirin's role is set to become more clearly defined based on past and prospective studies.
DATA SOURCES
Utilizing PubMed, the reviewers identified appropriate Medical Subject Headings (MeSH) terms to establish CVD-based studies, cancer-based studies, and studies on adherence.
STUDY ELIGIBILITY CRITERIA
Date restrictions of May 31, 2008 to May 31, 2013 were applied to capture the most robust meta-analyses and randomized controlled trials. Websites of relevant EU and US scientific societies were used to identify the key guidelines for aspirin use in primary prevention of CVD, and ClinicalTrials.gov was used to establish future or ongoing trials.
RESULTS
Evidence in support of aspirin prophylaxis is conflicting, though some meta-analyses have underlined potential benefit in reducing cardiovascular events. Despite this apparent benefit, bleeding risk with aspirin is consistently higher versus control, and remains a concern. A reduction of cancer incidence and mortality after a least 3 and 5 years treatment, respectively, is also apparent with aspirin.
CONCLUSION
Available data on aspirin in primary prevention suggest a modest benefit for patients at high risk of CVD, and a promising benefit for those at risk of cancer. Future studies should help to elucidate whether the benefit of aspirin outweighs risk in appropriate patient groups.
Topics: Aspirin; Cardiovascular Diseases; Humans; Platelet Aggregation Inhibitors; Primary Prevention; Prospective Studies; Randomized Controlled Trials as Topic; Time Factors
PubMed: 25502483
DOI: 10.1007/s40256-014-0100-5 -
Stroke Feb 2007Statins have been shown conclusively to reduce the risk of cardiovascular events in subjects with clinical cardiovascular disease or diabetes aged 65 to 80 years of age.... (Review)
Review
BACKGROUND AND PURPOSE
Statins have been shown conclusively to reduce the risk of cardiovascular events in subjects with clinical cardiovascular disease or diabetes aged 65 to 80 years of age. However, few data are available for primary prevention of cardiovascular disease in those aged > or =70 years.
SUMMARY OF REVIEW
A moderate-dose statin was of little benefit in a population aged 70 to 82 years when given for 3 years in the setting of suboptimally treated blood pressure. More evidence supports the use of blood pressure-lowering medications, but few data are available regarding the appropriate blood pressure target and most effective agents in the elderly. Some evidence also suggests that the elderly could experience higher mortality with antihypertensive treatment. These findings, along with greater safety concerns and an increasing number of competing risks and medical conditions with advancing age, make it imperative to carefully evaluate the risk/benefit balance from treating hypercholesterolemia and hypertension in persons aged > or =70 years.
CONCLUSIONS
We propose a 5-year 2x2 factorial trial of primary prevention in the elderly that will (1) evaluate whether statin therapy will reduce the risk of cardiovascular events when added to the treatment of hypertension to achieve a blood pressure <140/90 mm Hg in most patients and (2) determine the most appropriate blood pressure regimen for the prevention of cardiovascular and renal events.
Topics: Aged; Cardiovascular Diseases; Clinical Trials as Topic; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Primary Prevention; Time Factors
PubMed: 17194877
DOI: 10.1161/01.STR.0000254602.58896.d2 -
Journal of General Internal Medicine Feb 2015
Topics: Aspirin; Cardiovascular Diseases; Hemorrhage; Humans; Physician's Role; Primary Prevention
PubMed: 25451988
DOI: 10.1007/s11606-014-3108-2 -
Emergencias : Revista de La Sociedad...
Topics: Accidental Falls; Aged; Aged, 80 and over; Emergency Medical Services; Humans; Physician's Role; Primary Prevention
PubMed: 30033694
DOI: No ID Found -
Journal of Public Health Management and... 2017
Topics: Exercise; Feeding Behavior; Humans; Nicotine; Population Health; Primary Prevention; Public Health; Smoking
PubMed: 27870716
DOI: 10.1097/PHH.0000000000000485 -
Revue Medicale Suisse Mar 2020Low-dose aspirin in primary prevention of cardiovascular disease is still debated. Recent clinical trials of aspirin vs placebo reported an unfavourable risk-benefit... (Review)
Review
Low-dose aspirin in primary prevention of cardiovascular disease is still debated. Recent clinical trials of aspirin vs placebo reported an unfavourable risk-benefit ratio with an increase in major bleedings without reduction on the occurrence of non-fatal cardiovascular events. These studies also highlight that current cardiovascular risk calculators overestimate cardiovascular risk, which is probably related to the improvement in the management of cardiovascular risk factors over the last decades. In accordance with European cardiovascular prevention recommendations, aspirin should not be prescribed for the primary prevention of cardiovascular disease.
Topics: Aspirin; Cardiovascular Diseases; Hemorrhage; Humans; Primary Prevention; Risk Assessment
PubMed: 32134226
DOI: No ID Found -
Journal of the American Pharmacists... 2017The objectives of this project are 1) to describe aspirin use for primary prevention in an underserved, minority population; 2) to determine the impact of a...
OBJECTIVES
The objectives of this project are 1) to describe aspirin use for primary prevention in an underserved, minority population; 2) to determine the impact of a pharmacist-led intervention on the prevalence of aspirin use for primary prevention; and 3) to compare aspirin indications based on Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) risk score.
METHODS
Men and women age 45-79 and 55-79 years, respectively, without ASCVD were screened for aspirin use. An FRS of 10% or greater and low risk for a serious bleed were considered indications for primary prevention aspirin on the basis of guideline-directed medical therapy recommendations. When treatment with aspirin was indicated, providers were notified with patient-specific messages. Patients' FRS and ASCVD risk score distributions were plotted and compared. Primary prevention aspirin indications were identified using both risk stratification tools.
RESULTS
One hundred sixteen patients were evaluated for aspirin use in a predominantly black (80%), middle-aged (mean age, 58 years), and indigent population. Thirty-one patients (27%) had an FRS of 10% or greater and low risk for bleeding, and 10 patients (9%) were taking aspirin at baseline. Providers approved recommendations to start administering aspirin in 19 of 31 patients (61%), which significantly increased the overall proportion receiving aspirin compared to baseline (9%-25%; P < 0.01). Patients were more than twice as likely to meet the minimum risk score threshold (≥10%) for a primary prevention aspirin indication using ASCVD risk scores versus FRS (70% vs. 30%; P < 0.01).
CONCLUSIONS
Baseline utilization of primary prevention aspirin was low in an indigent, minority population. A provider-focused pharmacist intervention improved the prevalence of aspirin use for primary prevention, while minimizing risk for serious bleeding events. Among our cohort, more patients had indications for primary prevention aspirin using ASCVD risk scores versus FRS.
Topics: Black or African American; Aged; Aspirin; Cardiovascular Diseases; Female; Humans; Male; Middle Aged; Pharmacists; Primary Prevention; Professional Role; Risk Factors; Vulnerable Populations
PubMed: 28811088
DOI: 10.1016/j.japh.2017.07.003