The 2019 ESC/EAS guidelines introduced stricter low-density lipoprotein cholesterol (LDL-C) targets, particularly for patients at high and very high cardiovascular (CV) risk. However, data on the implementation of these targets in real-world clinical practice—especially in countries with high/very high CV risk—remain limited. The DISCOVERY study aimed to assess LDL-C management, lipid-lowering therapy (LLT) use, and guideline adherence across multiple countries in Central and Eastern Europe and Central Asia.This prospective, observational, multicenter study enrolled adult patients with hypercholesterolemia (HCL) from 10 countries grouped into three regions. Data was collected at baseline and after 12 weeks of follow-up. LLT patterns, LDL-C levels, target attainment (both investigator-defined and 2019 ESC/EAS-recommended), and physician adherence to guidelines were analyzed.A total of 6,447 patients were included; 53.2% were female, and the mean age was 60.5 ± 11.9 years. Most patients (66%) were in secondary prevention. At baseline, 36.8% had been treated with LLT. After the first visit, treatment was changed in 78% of patients, but only 42.4% received high-intensity statins and 9.3% received statin-ezetimibe combinations at follow-up. LDL-C target achievement was poor: only 5.6% of patients met the guideline-recommended LDL-C goals, compared to 45.5% who met physician-defined targets. Among patients with ASCVD, only 3.3% achieved guideline LDL-C targets. The most significant gap was observed between guideline recommendations and physician-set LDL-C goals. No significant difference in LDL-C target attainment was observed between specialists and general practitioners.The DISCOVERY study reveals suboptimal LDL-C control and low adherence to the 2019 ESC/EAS guidelines in routine practice across countries with high/very high CV risk. These findings highlight the urgent need for strategies to improve physician awareness, promote intensive LLT use, and close the gap between guidelines and clinical practice. A paradigm shift toward proactive LDL-C management is essential to reduce residual CV risk in these populations.

Introduction The COVID-19 pandemic has significantly impacted general medical practice by altering work structures and increasing teamwork while also adversely affecting the mental health of general practitioners and family medicine specialists. This study assesses depression, anxiety, and fear levels among general practitioners and family medicine specialists in Europe 2 years after the COVID-19 pandemic’s onset, and it explores influencing factors. Methods This observational cross-sectional study included participants from 13 European countries. Data was collected from May to August 2022 with an anonymous online survey incorporating validated questionnaires for depression (PHQ-9), anxiety (GAD-7), and fear of COVID-19 (FCV-19S). Data analysis involved descriptive statistics, correlation tests, and linear regression. Results A total of 1,723 participants completed the survey. Findings indicated an overall mild to moderate levels of anxiety (GAD-7: 5.4 ± 4.76) and depression (PHQ-9: 6.33 ± 5.43), and moderate fear of COVID-19 (FCV-19: 12.84 ± 5.29). Key determinants of anxiety, fear, and depression included country, at-risk status, patient non-compliance, and mental health history. Sex influenced anxiety and fear, losing co-workers to COVID-19 influenced anxiety and depression, while losing relatives or friends influenced fear. Conclusion Two years into the pandemic, European general practitioners and family medicine specialists showed mild to moderate levels of anxiety, depression, and fear. Country, at-risk status, mental health history, and work-related challenges significantly affected mental health. Crucial interventions are needed to support healthcare workers during pandemics, focusing on protective measures, stable work environments, and coping strategies for anxiety and depression.

Objectives. The main objective was to assess the relationship between sociodemographic and occupational factors and stress levels among healthcare workers in family medicine in Bosnia and Herzegovina, using the PSS-10-BH scale. Materials and Methods. A cross-sectional study was conducted using the PSS-10-BH questionnaire distributed via Google Forms to primary care nurses and physicians between July and August 2022. Results. The study included 272 participants, with a mean age of 44.7 (±10.55), predominantly women (86.8%) and physicians (58.8%). The mean PSS-10-BH total score for the sample was 21.26 (±6.77) ranging from 3 to 36. The linear regression model indicated male gender and older age showed an association with slightly lower stress levels. Marital status and the number of children showed a slight positive association with stress levels. Occupation (B=-3.068, 95% CI: -5.442 to -0.694, P=0.012) was associated with stress, with physicians tending to report lower stress levels compared to nurses. Years of work experience (B=0.060, 95% CI: -0.190 to 0.309, P=0.636), and patient load (B=0.082, 95% CI: 0.027 to 0.137, P=0.004) were associated with higher stress levels. The results suggest that work-related variables are significant predictors of stress levels as measured by the PSS-10-BH scale in this sample of healthcare workers. The included predictors explain 10% of the variability in the outcome, indicating additional unidentified contributing factors. Conclusion. Occupational factors, particularly profession, work experience, and daily patient load, significantly influence stress levels in healthcare workers. Further research is needed to explore other potential influences and refine interventions aimed at managing stress in this population.

Aim To assess the relationship between the attitudes of general practitioners/family medicine doctors (GP/FD) and of their patients toward industry-sponsored clinical research. Methods A cross-sectional survey included volunteer GPs/FDs who then enrolled and interviewed their patients. Data were analyzed in hierarchical models (patients nested in GPs/FDs, nested in countries/regions). Results A total of 201 GPs/FDs from nine European countries responded to the invitation and enrolled 995 of their patients. We observed mild associations between some of the GPs/FDs’ attitudes (general opinion on sponsored clinical studies, appreciation of the general values of such studies, views about the importance of participant protection/privacy) and some of the patients’ attitudes (appreciation of the general values and of risks associated with sponsored clinical studies, importance assigned to potential personal benefits from participation). We observed no association between GPs/FDs’ attitudes and patients’ willingness to participate in such studies. However, willingness to participate increased with higher patients’ appreciation of the general values of sponsored studies, decreased with higher patients’ appreciation of associated risks, and showed a quadratic trend across the levels of importance assigned by patients to potential personal benefits (willingness was higher when the assigned importance was very low or very high). More importance to GP/FD’s advice in this respect was assigned by patients who assigned more importance to potential personal benefits, who were better educated, and who resided in rural/suburban dwellings. Conclusions In the present convenience sample, lay-person attitudes about and willingness to participate in industry-sponsored clinical studies were associated with the attitudes of their GPs/FDs.

Aimof this study was to present data on addicts with the imposed protective measure of compulsory treatment of addition that were sent to the Institute for Addiction Diseases for the period 2014-2020. The study compares artsof law violation, art of addiction as well as duration of the protective measure of compulsory treatment.Out of 61 patients, 59 (96 %) were males and 2 (4%) females. The only reason for compulsory treatment for all of them was domestic violence. Out of 61 patients 41 (67%) underwent compulsory treatment due to use of psycho-active compounds (PAS) and 20 (33%) due to use of alcohol. Incidence of alcohol or PAS was statistically significant higher in males than in females (19 vs 1, p<0.001; 40 vs 1, p<0.001, respectively). Duration of the treatment was significantly longer in patients who used PAS than in those who used alcohol (10.29 vs 7.4 months; p<0.05). There was not statistically difference between duration ofthe treatment in males and females (9.36 vs 9.00 months; p>0.05). Incidence of the compulsory measures was significantly higher in 2018, 2019 and 2020 than in 2014, 2015 and 2016 (p<0.001). In all analyzed years, except 2015, incidence of the mandatory measureswas significantly higher in patients who misused PAS than who misused alcohol. The most common difficulties are:lowmotivational capacity,inadequate way of thinking, inadequateway of behaving with the adoption of new models and, ultimately, inadequate independent functioning. Keywords: addiction, compulsory treatment, violation of the law, criminal behaviour.

Objectives. The main objective of this paper was to examine the perceptions of family physicians on the use of primary health care in Bosnia and Herzegovina during the COVID-19 pandemic. Materials and Methods. A cross-sectional study was conducted using a short online questionnaire that was sent to primary care physicians in Bosnia and Herzegovina from April 20th, 2022, to May 20th, 2022. Results. The research sample consisted of 231 doctors of primary health care from Bosnia and Herzegovina, with an average age of 45 years and 85% women. About 70% of participants reported having COVID-19 at least once from March 2020 to March 2022. Participants had an average of 1,986 registered patients and approximately 50 encounters per day. The study revealed a high degree of reliability between test-retest measurements, with a single measure Intraclass correlation coefficient of 0.801, and internal consistency determined using Cronbach’s alpha of 0.89. Participants reported that the following health services were most affected during the COVID-19 pandemic: care for patients with chronic diseases, home visits, navigating the health system with patients making appointments with specialists, cancer screening, and preventive health services. The study also found statistically significant perceived differences in the use of these health services based on age, gender, postgraduate education in family medicine, participation in COVID-19 clinics, and personal history of Covid-19. Conclusion. There were significant disturbances to the use of primary health care during the COVID-19 pandemic. Future research could investigate patient outcomes compared to family physician perceptions.

Background: Hypertension is the most important risk factor for cardiovascular morbidity and mortality. Blood pressure control rates are as low as 17% to 31% in patients diagnosed with hypertension in high-income countries; control rates are likely poorer in low- to middle- and low-income countries. Blood pressure control rates are as low as 17% to 31% in patients diagnosed with hypertension in high-income countries; control rates are likely poorer in low- to middle- and low- income countries. Overall, 43% to 66% of patients fail to adhere to their prescribed antihypertensive medications, and after 1 year, ≈40% of patients with hypertension may stop their initial drug treatment. Objective: The aim of the study was to evaluate the effects of single pill combination antihypertensive drugs on the adherence to treatment, blood pressure control and cardiovascular events vs. free-combination therapy. Methods: We enrolled 192 adult hypertensive patients not older than 79 years, with untreated or uncontrolled hypertension despite previously receiving free combination antihypertensive therapy, between November 2020 and March 2022. Patients treated with single pill combination (SPC) were compared with an arm of the same size (n = 96) and matched by age and gender who received a standard free combination (FC) antihypertensive therapy. Results: There were significant reductions from baseline to month 6 of follow-up in office SBP in the SPC group vs. reduction in FC group (21.9 vs. 13.1 mmHg; p < 0.0001). There were significant reductions from baseline to month 6 of follow-up in office DBP in the SPC group vs. group with free-combination therapy (13.7 vs. 8.0 mmHg; p < 0.0001). At 6 months, 94 participants (98%) were still prescribed the SPC therapy. At the final 6-month study visit, 84.2% of patients in the SPC therapy group were adherent to the prescribed antihypertensive therapy vs. 52% of patients in the FC group. Target BP values (mean 24h ambulatory systolic/diastolic BP < 130/80 mmHg) were reached by more recipients of SPC than free-combination therapy (78.2% vs. 46.3%, p < 0.05) at month 6 of follow-up. Conclusion: Treatment with single pill combinations (SPC), is the emerging best practice for safe, effective, rapid, and convenient hypertension control. It improves the affordability, adherence and control of arterial hypertension.