Description
The programme provides universal screening for CVD risk factors in adults, followed by measures to reduce overall CVD risk and improve individual risk factors. For nearly 25 years, it has operated with these steps: 1. A basic screening questionnaire to prioritize preventive outpatient visits, 2. Cardiovascular risk assessment during family medicine/GP visits (including cholesterol and glucose tests), 3. Intervention through referrals for additional tests and systematic risk profile changes, focusing on lifestyle counselling and, if needed, medication or other treatments. The chronic noncommunicable diseases (NCD) prevention programme operates in over 1,100 family medicine clinics and 61 health promotion/education centres at primary health centres across Slovenia. Data from preventative visits are collected in uniform computer forms and integrated into GP software. A centralised data collection system supports the national "Registry of Individuals at High CVD Risk". Initially, due to limited resources, the programme targeted high-risk age groups (35-65 for men and 40-70 for women) to ensure preventative care for about 800,000 individuals over five years. From 2002 to 2012, there were 1,044,133 preventative screenings (73.5% of those planned), with 903,428 as first check-ups. Currently, the Together for Health programme at primary care level (https://www.skupajzazdravje.si/en/) supports healthier living for all adults in Slovenia (30+). From 2019-2023, 77,238 healthy people were screened, and 235,677 individuals with NCDs received services from registered nurses at family medicine/GPs. Health centres offer group or individual counselling for lifestyle improvements, including smoking cessation, healthier diets, physical activity, weight loss, and stress management.Program launch date
The comprehensive primary CVD prevention programme started nationwide in late 2001/early 2002. It was updated and replaced by "Health for All" after 2015 and is currently fully coordinated by the National Institute of Public Health.Responsible entity
National Health Fund. The programme is free for those with compulsory health insurance, including a preventive check-up, group workshops, individual consultations for lifestyle changes and mental health support, and various local health promotion activities.Available results and quality metrics
Individual hard CVD endpoints data is unavailable. However, using standardized death rate data and the IMPACT model approach, approximately 900 lives are saved annually due to primary prevention interventions in comparison to 2002. Notably, premature mortality from ischemic heart disease and stroke has been reduced by over 50%. The Together for Health program effectively improves lifestyles of those at risk of chronic diseases. The program"s success is measured through indicators reflecting changes in habits, well-being, and physiological parameters, mainly identifying short-term effects. In 2022, 28% of participants ate vegetables more frequently, and 36% reduced unhealthy snacks. In health-enhancing physical activity, 55% increased balance exercises, while 59% increased muscle-strengthening activities. Over half the participants in type 2 diabetes treatments felt strong enough to manage their diet and exercise. Regarding obesity, 54% of participants in 2022 lowered their body mass index by at least 1 point. In psychoeducation, half the participants believed more in their ability to improve their well-being and felt depression or anxiety could be overcome.Limitations / comments
Patient response rates for CVD risk screening and health services should be improved. Efforts should focus on developing reliable digital tools for systematic data collection and performance analysis.