Controlling cardiovascular diseases in low and middle income countries by placing proof in pragmatism

Area of Science:

• Public Health
• Implementation Science
• Cardiovascular Medicine

Background:

• Low and middle-income countries (LMICs) face a significant and increasing burden of cardiovascular disease (CVD).
• Limited resources and lack of pragmatic guidelines hinder effective CVD prevention, treatment, and rehabilitation in LMICs.
• Addressing the global CVD burden requires tailored strategies for LMICs.

Purpose of the Study:

• To present an implementation cycle for developing, contextualizing, communicating, and evaluating CVD recommendations for LMICs.
• To introduce a translatability scale for assessing the ease of implementing CVD recommendations in resource-limited settings.
• To provide strategies for stakeholder engagement and feedback enhancement in CVD management.

Main Methods:

• Development of an implementation cycle framework for CVD recommendations.
• Creation of a translatability scale to rank recommendation implementability.
• Prescription of stakeholder engagement strategies (providers, patients, policymakers).
• Formulation of feedback enhancement mechanisms.

Main Results:

• The proposed implementation cycle offers a structured approach to adapt and apply CVD guidelines in LMICs.
• The translatability scale aids in prioritizing feasible CVD interventions.
• Stakeholder engagement strategies facilitate the practical application of recommendations.
• Feedback mechanisms promote continuous improvement in CVD care.

Conclusions:

• This implementation cycle and translatability scale can help LMICs combat CVD despite resource constraints.
• The approach can stimulate new hypotheses and research in implementation science for CVD.
• Effective CVD management in LMICs is achievable through tailored, resource-aware strategies.