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From Concept to Preliminary Results AMEE 2009 Malaga, Spain

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From Concept to Preliminary Results AMEE 2009 Malaga, Spain

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    2. To promote life long learning through continuing professional development among family physicians and general practitioners in mid and lower income countries by developing programs, standards, resources and partnerships that foster higher quality care for patients and communities Our Mission—Shift of Emphasis from Live long Learning to the Quality of Primary Health Care Services

    3. A Four-Year Journey from Concept to Implementation & Results

    4. Initial Steering Committee, MD, co-chairs)

    5. Board of Directors 2008--2009

    6. Involve a significant number of primary care physicians in participating countries Improve at least three morbidity or mortality measures in served populations by measuring bio-markers Improve measured knowledge levels in curriculum areas amongst participating physicians Build a core curriculum for physicians working in primary health care services Identify and test Global CME/CPD standards to be accepted and published Expand life-long medical learning to non-physician health providers and patients Goals

    7. Pilot Educational Program: Cardiovascular Disease Risk Factors Why? Cardiovascular Disease (CVD) accounts for 29.2% of total global deaths; Approximately 80 % of these deaths are in emerging countries; Economic burden on the health systems Availability of surrogate measures Educational Intervention

    8. Projected Leading Causes of Death 2030

    9. Blended learning approach: Standard tool: Online self directed learning activity Reinforcement tools: facilitated face-to-face discussions, self assessment exercises, online discussion board, reminders Enabling tools: reference lists, best practice guidelines, patient education materials and tools Alternating Methods: In-country orientation, online didactic, in-country clinic, online didactice etc. etc. Focus on Practice Improvement: Physicians assess CV risk level of cohort of patients Physicians establish treatment goals In-country sessions aimed at practice improvement planning and problem solving Data on patient progress provided to physicians Pilot course design

    10. Inclusion Criteria Primary Care Physicians Hospitals/ Private Practices Attending > 100 patients with CV RF/month Practicing in the Project GLOBE pilot country Internet Connection Access to computer Working knowledge of English Consenting to the protocol Study participants Exclusion Medical Students Non Primary Care PCPs not interested in participation

    11. % of Patients with controlled Cholesterol level ( goal < 200 mg/dL [ 6.2 mMol/L] % of Patients with controlled hypertension ( goal < 140/90 mm Hg) Primary endpoints:

    12. Physician’s knowledge (tests) Physician's satisfaction (tests, interviews) Attitudes (interviews) Additional secondary endpoints % of Patients with smoking behavior % of Diabetic patients with controlled blood glucose ( < 110 mg/dL) Mean BMI (lean, <25; overweight, 25-29; and obese, 30) or weight in the total patient population / waist circunference Changes in Risk Factor Score (Framingham) Secondary enpoints:

    13. Evaluation

    14. Sponsors

    15. Support, Partners and Participating Countries

    16. Project Timeline

    17. Felix Vartanyan, MD Project Globe in the Russian Federation

    18. Administrative Structure of Project Globe in Moscow

    19. Main Components of Comprehensive Training Program

    20. Formation Process of Competention

    21. Model of Project Globe Development

    22. Moscow Polyclinics Involved in Project Globe Study*

    23. Tripartite System

    24. Interaction Between Training and Practice

    25. Data Entry Forms

    26. Demographic Breakdown

    27. Risk Factors: Preliminary Results* % Change from Initial Visit to 3 Months n=574

    28. Preliminary Results by Gender* % Change from Initial Visit to 3 Months n=574

    29. Preliminary Results for Hypertension by Grade* % Change from Initial Visit to 3 Months n=549

    30. Preliminary Results for High Total Cholesterol subjects* % Change from Initial Visit to 3 Months n=420

    32. Development of Project Globe Venezuela Building Pilot Relationships between PGC and local leaders Let's make a photographic look at each stage of the project have been met in VenezuelaLet's make a photographic look at each stage of the project have been met in Venezuela

    33. Identifying Needs & Priority Diseases Then we proceeded to investigate the needs and priorities in health and education of general and family physiciansThen we proceeded to investigate the needs and priorities in health and education of general and family physicians

    34. Pilot Studies – Proof of Concept After we selection ambulatories, physicians and patientsAfter we selection ambulatories, physicians and patients

    35. Then we performThen we perform

    36. Course Design After we course designAfter we course design

    37. is a student-centered instructional strategy in which students solve problems and reflect on their experiences is a student-centered instructional strategy in which students solve problems and reflect on their experiences

    38. Pilot Studies – Proof of Concept Course Implementation in the implementing the activities were conducted face to face and online activities. in the implementing the activities were conducted face to face and online activities.

    43. Data Review and Impact -- Demographic Breakdown n=245 most patients are in the age sixty or more, and hypertension grade 1 and female, and hypercolesterolemia buscar most patients are in the age sixty or more, and hypertension grade 1 and female, and hypercolesterolemia buscar

    44. Risk Factors: Preliminary Results % Change from Initial Visit to 3 Months n=245 at baseline and controls at 3 months shows. Significant values increase XXXX and decrease of XXXXX at baseline and controls at 3 months shows. Significant values increase XXXX and decrease of XXXXX

    45. Preliminary Results by Gender % Change from Initial Visit to 3 Months n=245 when comparing men and women is seen predominantly in men over women post intervention when comparing men and women is seen predominantly in men over women post intervention

    46. Preliminary Results for Hypertension by Grade % Change from Initial Visit to 3 Months n=245 Here we see the difference in the type of hypertensionHere we see the difference in the type of hypertension

    47. Preliminary Results for Smoking and Weight Change from Initial Visit to 3 Months Here we appreciate the improvement in lifestylesHere we appreciate the improvement in lifestyles

    48. Course Satisfaction Feedback n=64 The average satisfaction feedback of the course participants between Agree and totally agreeThe average satisfaction feedback of the course participants between Agree and totally agree

    49. In the baseline cognitive assessment most was unless 3 and at 3 months most were above 7.5 and all at or than 5In the baseline cognitive assessment most was unless 3 and at 3 months most were above 7.5 and all at or than 5

    50. It was significantIt was significant

    51. Next Steps And we conclude And we conclude

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