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Introduction We evaluated the IraPEN program, a localized adaptation of the WHO PEN initiative in Iran, with respect to cardiovascular disease and hypertension screening and management. Methods A cross-sectional ecological study utilizing the Input-Process-Output-Outcome framework was conducted during 2020–2021. Aggregated data from non-communicable disease (NCD) facilities were collected and analyzed by urban/rural primary healthcare settings. Results The study evaluated 610 NCD facilities, serving 1.8 million adults aged ≥ 30, of whom 515,488 underwent 10-year WHO/ISH CVD risk scoring and hypertension assessment, indicating coverage of 30%. Input/process showed all NCD facilities had functional blood pressure devices, 87% had POCT for measurement of glucose and cholesterol and 14% experienced medication stock-outs in the past three months. All staff received CVD risk scoring training, with 60% re-trained during the last two years. Output/outcome indicators revealed 3% of individuals were at moderate risk (CVD risk 10–19%), 0.6% at high risk (20–29%), 0.9% at very high risk (≥ 30%), and 2.7% had a prior CVD history. Prevalence of hypertension was 17%, compared with a national survey, indicating an observed-to-expected ratio of 55%. 80% of patients with hypertension received blood pressure-lowering medications, and 74% of them achieved blood pressure control; 38% of CVD patients received antiplatelet/anticoagulant therapy, and 66% of eligible patients took statins. Conclusion IraPEN demonstrated low coverage for CVD risk scoring and hypertension detection but acceptable treatment and control rates. Management of patients with CVD seems suboptimal. The WHO/ISH CVD risk scoring may lack in detecting high and very high-risk individuals.

Objective The purpose of this study was to evaluate the results of providing heart disease risk assessment services in order to determine the information needs for the necessary interventions in the comprehensive health service centers of Ardabil province. Methods The present descriptive and analytical study was conducted in Ardabil University of Medical Sciences from March 2019 to the end of 2020, and used the data available in the registration system of the health network system. The sample size was determined based on the formula of 256 people. Based on the information from integrated health system (SIB), the values of the first screening variables and risk score were extracted. After that, these values were also recorded in the second screening. Results Most of the patients were married, urban, and in the age group of 60–69. The highest history of risk factors in the target group was high blood pressure at 52% and diabetes mellitus (DM) at 49.2%, respectively, and alcohol consumption was the lowest at 3.2%. The paired t test shows, the difference in the patient’s cholesterol level, systolic blood pressure and diastolic blood pressure in the first screening compared to the second had statistical significance ( p  < 0.001). Conclusion The results of the study showed that in Ardabil province, the implementation of the risk assessment program reduces heart disease risk by affecting cholesterol, systolic blood pressure, and diastolic blood pressure. This means that many premature deaths caused by heart disease can be prevented, by increasing people’s awareness and the efforts of healthcare providers in Iran.

Objectives This study evaluated the effectiveness of the IraPEN program, an adapted version of the WHO Package of Essential Non-communicable Disease (PEN) intervention, in managing diabetes from September 2020 to September 2021 using the Input-Process-Output-Outcome framework. Methods In this Cross-sectional/Ecological study, aggregated data was collected from IraPEN facilities by medical universities using the electronic health system. The data was presented as numbers and proportions, for urban and rural healthcare facilities separately. Results The study surveyed 610 NCD facilities from184 comprehensive health centers under the supervision of 56 medical universities, which provided services to 1,785,226 individuals aged > = 30 years. In terms of input/process, 78% of NCD facilities had functional point-of-care testing, and 14% of health centers with drugstore experienced a stock-out of core medications during the past three months. In urban facilities, 66% had at least a trained nutritionist, and 82% trained psychologist. Regarding output/outcome, 26% of expected diabetes and 23% of expected pre-diabetes, as estimated by the STEPS 2016 survey, were enrolled in NCD facilities, with higher rates in rural than urban areas. Among the referred patients, 38.7% took statins, 53% visited a physician in the last three months, 57.2% were referred for dietary assessment, and 72.5% were referred to secondary care. Around 39% of diabetic patients with at least one HbA1c laboratory test had good glycemic control. Conclusions The IraPEN program has managed only a quarter of diabetic patients, and less than half of them are in good glycemic control. Urgent improvements, mainly in coverage and effectiveness, are necessary.