Integrated Measurement for Early Detection (MIDO) as a digital strategy for timely assessment of non-communicable disease profiles and factors associated with unawareness and control: a retrospective observational study in primary healthcare facilities in Mexico.

Autor:	Gallardo-Rincón H; Health Sciences University Center (CUCS-UdeG), University of Guadalajara, Guadalajara, Jalisco, México., Montoya A; Carlos Slim Foundation, México City, Mexico airainmr@fundacioncarlosslim.org., Saucedo-Martínez R; Carlos Slim Foundation, México City, Mexico., Mújica-Rosales R; Carlos Slim Foundation, México City, Mexico., Suárez-Idueta L; Carlos Slim Foundation, México City, Mexico., Martínez-Juárez LA; Carlos Slim Foundation, México City, Mexico.; London School of Hygiene & Tropical Medicine, London, UK., Razo C; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA., Lozano R; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA., Tapia-Conyer R; Carlos Slim Foundation, México City, Mexico.; School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Sep 02; Vol. 11 (9), pp. e049836. Date of Electronic Publication: 2021 Sep 02.
DOI:	10.1136/bmjopen-2021-049836
Abstrakt:	Objectives: The Carlos Slim Foundation implemented the Integrated Measurement for Early Detection (MIDO), a screening strategy for non-communicable diseases (NCDs) in Mexico as part of CASALUD, a portfolio of digital health services focusing on healthcare delivery and prevention/management of NCDs. We investigated the disease profile of the screened population and evaluated MIDO's contribution to the continuum of care of the main NCDs. Design: Using data from MIDO and the chronic diseases information system, we quantified the proportion of the population screened and diagnosed with NCDs, and measured care linkage/retention and level of control achieved. We analysed comorbidity patterns and estimated prevalence of predisease stages. Finally, we estimated characteristics associated with unawareness and control of NCDs, and examined efficacy of the CASALUD model in improving NCD control. Setting: Public primary health centres in 27/32 Mexican states. Participants: Individuals aged ≥20 years lacking healthcare access. Results: From 2014 to 2018, 743 000 individuals were screened using MIDO. A predisease or disease condition was detected in ≥70% of the population who were unaware of their NCD status. The screening identified 38 417 new cases of type 2 diabetes, 53 133 new cases of hypertension and 208 627 individuals with obesity. Dyslipidaemia was found in 77.3% of individuals with available blood samples. Comorbidities were highly prevalent, especially in people with obesity. Only 5.47% (n=17 774) of individuals were linked with their corresponding primary health centre. Factors associated with unawareness of and uncontrolled NCDs were sex, age, and social determinants, for example, rural/urban environment, access to healthcare service, and education level. Patients with type 2 diabetes treated at clinics under the CASALUD model were more likely to achieve disease control (OR: 1.32, 95% CI: 1.09 to 1.61). Conclusion: Patient-centred screening strategies such as MIDO are urgently needed to improve screening, access, retention and control for patients with NCDs. Competing Interests: Competing interests: The authors HGR, AM, RSM, RMR, LSI, LAMJ and RTC are employed by the Carlos Slim Foundation in Mexico, the developer of MIDO and MIDO Plus. RTC is also affiliated with the School of Medicine of the National Autonomous University of Mexico (UNAM). CR and RL received compensation from the Carlos Slim Foundation for their contributions to this study and the manuscript. The authors declare that no other outside funding was received from any other organisations and declare no further conflicts of interest. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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