Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/273505 
Year of Publication: 
2023
Citation: 
[Journal:] BMC Public Health [ISSN:] 1471-2458 [Volume:] 23 [Issue:] 1 [Article No.:] 1152 [Publisher:] Springer Science and Business Media LLC [Place:] Berlin/Heidelberg [Year:] 2023 [Pages:] --
Publisher: 
Springer Science and Business Media LLC, Berlin/Heidelberg
Abstract: 
Hypertension (HTN) and diabetes mellitus (DM) as part of non-communicable diseases are among the most common causes of death worldwide, especially in the WHO’s Eastern Mediterranean Region (EMR). The family physician program (FPP) proposed by WHO is a health strategy to provide primary health care and improve the community’s awareness of non-communicable diseases. Since there was no clear focus on the causal effect of FPP on the prevalence, screening, and awareness of HTN and DM, the primary objective of this study is to determine the causal effect of FPP on these factors in Iran, which is an EMR country. We conducted a repeated cross-sectional design based on two independent surveys of 42,776 adult participants in 2011 and 2016, of which 2301 individuals were selected from two regions where the family physician program was implemented (FPP) and where it wasn't (non-FPP). We used an Inverse Probability Weighting difference-in-differences and Targeted Maximum Likelihood Estimation analysis to estimate the average treatment effects on treated (ATT) using R version 4.1.1. The FPP implementation increased the screening (ATT = 36%, 95% CI: (27%, 45%), P -value < 0.001) and the control of hypertension (ATT = 26%, 95% CI: (1%, 52%), P -value = 0.03) based on 2017 ACC/AHA guidelines that these results were in keeping with JNC7. There was no causal effect in other indexes, such as prevalence, awareness, and treatment. The DM screening (ATT = 20%, 95% CI: (6%, 34%), P -value = 0.004) and awareness (ATT = 14%, 95% CI: (1%, 27%), P -value = 0.042) were significantly increased among FPP administered region. However, the treatment of HTN decreased (ATT = -32%, 95% CI: (-59%, -5%), P -value = 0.012). This study has identified some limitations related to the FPP in managing HTN and DM, and presented solutions to solve them in two general categories. Thus, we recommend that the FPP be revised before the generalization of the program to other parts of Iran.
Subjects: 
Family physician program
Hypertension
Diabetes mellitus
Diference-in-diference
TMLE
Iran
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article
Document Version: 
Published Version

Files in This Item:
File
Size





Items in EconStor are protected by copyright, with all rights reserved, unless otherwise indicated.