Moser, Richard

Purpose: Despite the large impact heart disease has on morbidity and mortality, many are unaware of the risk factors and the steps they can take to reduce their own risk. Participation in clinical trials for discovering new approaches for the prevention and treatment of heart disease is important. This study sought to determine interest in participation in clinical trials of those diagnosed with heart disease and hypertension as compared to those without such diagnoses, and to assess associated sociodemographic characteristics of interest in participation Methods: Analyses were conducted using data from the 2014 administration of the National Cancer Institute's Health Information National Trends Survey . HINTS is a nationally-representative survey of the US adult (18+) population. The primary outcome of interest was whether respondents expressed interest in participating in research. Bivariate analyses were conducted initially to explore potential associations between sociodemographic factors and having had a diagnosis of hypertension or heart disease. Multivariate logistic regression was used to assess relationships between sociodemographic factors and outcomes, controlling for relevant sociodemographic characteristics and prior diagnosis of hypertension or heart attack. Weighted analyses were done to obtain population-level estimates. Findings: Of the 3,498 respondents, 1,569 (33.3%,) reported having a prior diagnosis of hypertension; 362 of 3,493 (7.0%,) respondents indicated that they had a previously diagnosed heart condition. Logistic regression showed that younger hypertensive participants had higher odds of being interested in participating in clinical trials as compared to those aged 75 years and older (OR = 3.62, 95% CI = 1.94-6.78). Those with regular care providers had higher odds of being interested in clinical trial participation compared to those without regular providers (OR = 1.51, 95% CI = 1.07-2.11). Likewise, younger participants aged 18-34 reporting heart conditions (OR = 3.58, 95% CI = 1.79-7.16) had higher odds of being interested in clinical trial participation compared to those aged 75 and older. No statistical differences were seen in clinical trial awareness, participation, or interest across race or gender. Conclusions: Participants who have a diagnosis of heart disease or hypertension and report being interested in engaging in clinical trial research are generally younger and have a regular health care provider. Therefore, behavioral intervention efforts should focus on translating clinical trial participation interest to participation in younger adults. Clinical trial recruitment efforts should also focus on unique methods to increase interest and subsequent trial enrollment in older adults and those without regularly provided care.

AbstractAfter decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced‐based argument for the fundamental role of surgery and anaesthesia within cost‐effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.