Efficiency of the competence-based prevention model of ischemic stroke in the system “elderly patient — family”

Introduction. High morbidity of ischemic stroke (IS) in modern time of the cardiovascular complications (CVC) risk factors population management strategy application of determines the need to improve the prevention model.

 Purpose of the research: to develop a competence-based prevention model of IS in the “elderly patient — patients’ family” system at the primary health care (PHC) level and to evaluate its effectiveness.

 Material and methods. А retrospective, multicenter research was in 2021–2024. Objects of the research: patients (n = 233), average age 66 ± 8.7 years, with chronic cardiovascular diseases (CVD) and risk factors of IS; family members of patients (n = 233): group A (n = 114) — aged 40–60 years and group B (n = 119) — aged over 60 years. The subject of the research is the clinical organizational processes of the competency-based prevention model of IS and the medical social effectiveness of the model, including the coverage of preventive medical examinations, the achievement of final clinical cardiovascular points (IS, myocardial infarction (MI), death from CVC). The follow-up period is 36 months. Research methods: content analysis, statistical, comparative analysis, mathematical, clinical organizational modeling.

Results. The developed model is based on the competence activity of doctors in identifying and modifying CVC risk factors. ALL patients had a “very high” risk of CVC, including IS and MI, amounting to 16–47% for women and 26-51% for men. Among family members of patients in group A, a “high” risk of CVC was in 67.5% of the subjects; “medium” — in 10.5% and “low” — in 21.9%. All family members of patients in group B had a “high” risk of CVC, amounting to 36-42% for men and 24–30% for women. The coverage of patients and their family members with medical examinations and preventive check-ups was 100% during 36 months of follow-up. The endpoints of clinical cardiovascular events were not reached in 97.2% of patients and 100% of their family members.

Conclusion. Сompetency-based CVС prevention at the primary care level contributes to the medical social effectiveness of the developed model in the “elderly patient-patients family” system and the prevention of IS and mortality of patients and their family members from CVC, regardless of personal cardiovascular risk.

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