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                                        • Effectiveness of national strategies for non-communicable diseases

                                        Effectiveness of national strategies for non-communicable diseases

                                        Adobestock-386433869-von-andreas
                                        Research area: Prevention and screening

                                        Project leaders: Inanna Reinsperger

                                        Project team: Lucia Gassner, Inanna Reinsperger

                                        Duration: April 2021 – November 2021
                                        Language: English with German summary
                                        Suggested by: Federal Ministry of Social Affairs, Health, Care and Consumer Protection

                                        Publication: HTA Project Report No. 139:  https://eprints.aihta.at/1349/

                                        Background: Non-communicable diseases (NCD) are conditions that include, e.g., diabetes, cardiovascular diseases, cancer, chronic respiratory diseases, and mental disorders. These diseases account for 86 per cent of all deaths and 77 per cent of disease burden in the WHO European Region [1].

                                        Many western countries apply strategies to prevent and manage NCDs in order to improve the care for chronically ill people and extend the number of healthy life years (HLY), i.e., the number of years that a person is expected to continue to live in a healthy condition (without limitation in functioning and disability) [2]. The ten Austrian health targets, developed in 2012, aim to prolong the HLY of all people living in Austria within 20 years [3]. Austria significantly lags behind other countries in terms of healthy life years: In 2019, the number of HLY at birth was estimated at 58 years for women and 56.7 years for men in Austria. In contrast, the mean number of HLY in the European Union is 65.1 for women and 64.2 for men [4].

                                        Therefore, the question arises which national strategies to prevent and manage NCDs are used in different countries and which specific interventions/programmes are implemented and evaluated. The analysis focuses on diabetes type II, cardiovascular diseases, chronic respiratory diseases, and depression.

                                        Aim of the project: The project aims

                                        • to provide an overview of national strategies for preventing and managing NCDs (diabetes type II, cardiovascular diseases, chronic respiratory diseases, depression) in selected (Western industrialised) countries and their implementation, and
                                        • to summarise evaluation results for specific programmes/interventions/measures of the identified national strategies concerning the mentioned NCDs.

                                        Research questions (RQ): The following research questions will be answered:

                                        RQ1: Which national strategies/policies (at a macro level) are in place in Western industrialised countries in relation to the aforementioned NCDs and their risk factors?

                                        RQ2: What information is available on the implementation and implementation process? Which specific programmes/interventions/measures (at a micro level, e.g., disease management programmes) are described in the national strategies?

                                        RQ3: Which evaluation results of these programmes/interventions/measures (e.g., on implementation, effectiveness) can be summarised?

                                        Methods: These three research questions will be answered using the following methods:

                                        RQ1: Mapping of national strategies (at a macro level) in Western industrialised countries in relation to the above mentioned NCDs and their risk factors

                                        • Systematic hand search for national strategies/policies addressing the four NCDs mentioned above (e.g. in PubMed, Google Scholar, TRIP database, WHO, OECD, websites of ministries of health and public health institutions)
                                        • If applicable, contacting experts to identify relevant national strategies
                                        • Tabular presentation and description of the identified national strategies on country level (e.g. title, year, indications, focus [prevention, management], objectives)

                                        RQ2: Information on the implementation (process) and specific programmes/interventions/measures (at a micro level, e.g., disease management programmes) of the national strategies identified in RQ1

                                        • Analysis of the national strategies (and, if applicable, further documents) concerning information on the (planned) implementation (process) (e.g. time frame, actors involved, organisational framework, monitoring) and tabular presentation
                                        • Tabular presentation and description of the specific programmes/interventions/measures mentioned in the national strategies (e.g. target groups, professional groups involved, setting, programme content, duration/scope of the intervention, objectives)
                                        • Preparation of a ‘shortlist’ (selection) of potentially relevant programmes/interventions/measures by country, which will be analysed in more detail in the context of RQ3

                                        RQ3: Evaluation results of the programmes/interventions/measures

                                        • Targeted country-specific hand search for evaluation reports and/or published studies on the programmes/interventions/measures selected in the ‘shortlist’
                                        • If applicable, contacting relevant experts (from ministries, etc.) to identify relevant evaluation reports
                                        • If applicable, systematic (country-specific) search for evaluations of measures
                                        • Assessment of the evaluation reports’ quality using Risk of Bias tools (depending on the study design)
                                        • Data extraction and synthesis

                                        Inclusion criteria for relevant evaluation reports (RQ1+2)

                                        Description

                                        Project scope

                                        Type of publication

                                        National strategies and policies, which address one of the four NCDs (diabetes type II, cardiovascular diseases, chronic pulmonary/respiratory diseases, depression)

                                        Outcomes

                                        • main characteristics (e.g., title, year, indications, focus, aims)
                                        • information on the (planned) implementation process (e.g., time frame, involved stakeholders, organisational framework conditions, monitoring)
                                        • specific programmes/interventions/measures (e.g., target groups, professional groups involved, setting, programme content, duration/scope of intervention, aims)

                                        Settings

                                         

                                        Western industrialised countries (Europe, North America, Australia, New Zealand)

                                        Languages

                                        English, German

                                        Inclusion criteria for relevant evaluation reports (RQ3)

                                        Description

                                        Project scope

                                         Intervention

                                        Specific programmes/interventions/measures (e.g., Disease management programme [DMP], Case management, Prevention programme) for adults suffering from one of the four NCDs (diabetes type II, cardiovascular diseases, chronic pulmonary/respiratory diseases, depression) or adults with risk factors of these diseases

                                        • not: measures of control and design outside the health care system (e.g., taxation of sugary drinks)

                                        Outcomes

                                        • Effectiveness outcomes (e.g., mortality, morbidity, hospitalisation, quality of life, health care utilisation, patient satisfaction, symptoms improvement)
                                        • Implementation outcomes (e.g., implementation status, achievement of programme targets, acceptance)

                                        Study design

                                        Evaluation studies, reports and published studies

                                        Settings

                                         

                                        Western industrialised countries (Europe, North America, Australia, New Zealand)

                                        Languages

                                        English, German

                                        The workflow is organised according to the principle of dual control (LG, IR), and the results are subject to internal and external reviewers.

                                        Schedule/milestones

                                        Period

                                        Tasks

                                        April 2021

                                        Scoping, project protocol

                                        May to June 2021

                                        RQ1:

                                        • Systematic hand search for strategies/policies
                                        • If applicable, contacting experts
                                        • Tabular presentation and description of identified national strategies at country level

                                        Milestone 1: Table of national strategies at country level

                                        June to July 2021

                                        RQ2:

                                        • Analysis of the national strategies concerning the implementation process
                                        • Tabular presentation/description of specific programmes/interventions mentioned in the strategies
                                        • Shortlist (selection) of potentially relevant programmes/interventions by country

                                        Milestone 2: ‘Shortlist’ of specific programmes/interventions

                                        July to September 2021

                                        RQ3:

                                        • Targeted country-specific hand search for evaluation reports on the selected programmes/interventions
                                        • If applicable, contacting experts
                                        • Quality assessment of evaluation reports, data extraction and synthesis

                                        Milestone 3: Table of evaluation results of specific programmes/ interventions by NCDs

                                        October 2021

                                        Finalisation of the report, internal and external review

                                        November 2021

                                        Layout and publication of the report

                                        References

                                        [1] WHO. https://www.euro.who.int/de/health-topics/noncommunicable-diseases/ncd-background-information/what-are-noncommunicable-diseases

                                        [2] Eurostat, 2015. Glossary: Healthy life years (HLY). https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Glossary:Healthy_life_years_(HLY)

                                        [3] Österreichische Gesundheitsziele, 2012. https://gesundheitsziele-oesterreich.at/10-ziele/

                                        [4] Eurostat, 2021. Statistics Explained: Healthy life years statistics. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthy_life_years_statistics

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