Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: : Perception evaluation for managing Cardiovascular risk and patient inertia study (PACE STUDY)

Cardiovascular diseases (CVD) are the leading cause of death and disability in the world. It was responsible for 31.8% of all deaths and 14.7% of Disability Adjusted Life Years (DALYs) globally in the year 2017. According to the findings of the Global Burden of Disease study group, globally, there were an estimated 422 million prevalent cases of CVD in 2015, the largest contributor being the South Asian region.

Cardiovascular diseases (CVD) are the leading cause of death and disability in India. The CVD epidemic in Indians is characterized by a higher relative risk burden, an earlier age of onset, higher case fatality and higher premature deaths.

In accordance with the World Health Organization, India accounts for one-fifth of these deaths worldwide especially in younger population. The results of Global Burden of Disease study state age-standardized CVD death rate of 272 per 100000 population in India which is much higher than that of global average of 235. CVDs strike Indians a decade earlier than the western population.

The direct as well as indirect effects of an improving economy and rapid urbanization have led to an increase in risk factors associated with CVDs including high blood pressure (BP), obesity, diabetes mellitus, dyslipidemia, decreased physical activity, stress, substance abuse and novel risk factors such as air pollution.

Despite overwhelming evidence, however, a large majority of eligible patients do not receive appropriate care for cardiovascular risk factors. In tertiary hospitals, the combination of 4 evidence-based medicines (aspirin, β-blocker, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins) was prescribed only to 54% of eligible patients with coronary heart disease, whereas the rates were despairingly low in secondary (28%) and primary care (7%) clinics. The PURE study, which involved 5650 self-reported IHD and 2292 stroke participants, observed noticeable underuse of proven therapies for IHD in low-income countries (83% of the low-income country participants in the study were from India). As many as 80% of the participants with CVD were not on any of the 4 evidence-based secondary prevention drugs (aspirin, β-blocker, angiotensin-converting enzyme inhibitors, and statins) in the low-income countries, in comparison with 11% of participants in high-income countries.Improving adherence to prescribed therapies also requires the use of newer strategies.

The purpose of this survey is to understand the current perceptions on managing CV risk and underlying need gaps driving patient inertia and also help to address the current need gaps to look at potential interventions at patient level.

If you agree to participate, you will need to provide assessment response, on to the standard questionnaire form. A link will be provided for the same on your registered email address.

We trust you and we are partners in safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey.

If you agree to participate in the said study, we would request you to sign and return the enclosed reply along with your visiting card for accuracy of records.