Pol­i­cy rec­om­men­da­tions

The types of bar­ri­ers iden­ti­fied as pre­vent­ing indi­vid­u­als with VHD in Sau­di Ara­bia from access­ing treat­ment sug­gest three pri­or­i­ty areas where pol­i­cy action can be tak­en. Sev­er­al rec­om­men­da­tions have been deter­mined for each area that could improve the patient jour­ney.

Raise aware­ness of VHD among the pub­lic and HCPs

This can be done through pub­lic edu­ca­tion cam­paigns, train­ing pro­grams for health care work­ers, and sup­port for research on VHD.

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Raise aware­ness among the pub­lic and HCPs

Raise pub­lic aware­ness of VHD symp­toms to avoid mis­at­tri­bu­tion of symp­toms to old age and ensure that peo­ple know when to seek care. This can be achieved through tar­get­ed edu­ca­tion­al cam­paigns and out­reach pro­grams for at-risk pop­u­la­tions, par­tic­u­lar­ly the elder­ly. These can be sup­port­ed by car­di­ol­o­gists increas­ing their efforts to reach patients with­in their com­mu­ni­ties by going out to the com­mu­ni­ty.

Improve under­stand­ing of VHD in the med­ical pro­fes­sion by inte­grat­ing VHD into med­ical cur­ric­u­la and pro­vid­ing con­tin­ued train­ing, par­tic­u­lar­ly for PCPs, to enable time­ly detec­tion of VHD through rou­tine screen­ing and aus­cul­ta­tion of elder­ly patients.

Sup­port epi­demi­o­log­i­cal research to inform health pol­i­cy. Fund­ing stud­ies on the preva­lence of VHDs such as aor­tic steno­sis can pro­vide vital data to guide health pol­i­cy devel­op­ment. This includes tai­lor­ing aware­ness cam­paigns and med­ical edu­ca­tion pro­grams and opti­miz­ing resource allo­ca­tion for treat­ment ser­vices based on pop­u­la­tion needs.

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Ensure time­ly diag­no­sis and clear refer­ral path­ways

This can be done by increas­ing the avail­abil­i­ty of diag­nos­tic tools and treat­ment facil­i­ties, and by pro­vid­ing finan­cial assis­tance to patients who need VHD surgery.

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Ensure time­ly diag­no­sis and clear refer­ral path­ways

Invest in and con­duct rou­tine screen­ings at all lev­els of care to ensure time­ly diag­no­sis of VHD and link­age to care. Incen­tivize screen­ing in pri­ma­ry care by incor­po­rat­ing aus­cul­ta­tion of old­er patients into stan­dard pro­to­cols and per­for­mance met­rics. At high­er lev­els of care, con­duct rou­tine ECGs for elder­ly patients who have bypassed pri­ma­ry care. Pay­ers could also cre­ate finan­cial incen­tives to improve detec­tion rates.

Equip pri­ma­ry care HCPs with the knowl­edge and skills required to con­duct echocar­dio­grams. Tech­ni­cians must be trained to per­form this task effec­tive­ly and be pro­vid­ed with access to cen­ters that can sup­port them remote­ly with read­ing echocar­dio­grams.

Imple­ment refer­ral pro­to­cols for echocar­dio­g­ra­phy to enable prompt diag­no­sis and link­age to care when heart mur­murs are detect­ed in pri­ma­ry care. Stan­dard­iza­tion expe­dites diag­no­sis and treat­ment while enhanc­ing coor­di­na­tion between pri­ma­ry care and car­di­ol­o­gy.

Enable col­lab­o­ra­tion with car­di­ol­o­gists to enhance clin­i­cal knowl­edge of heart con­di­tions at the pri­ma­ry care lev­el and allow PCPs to con­sult spe­cial­ists. This can be achieved by pro­vid­ing car­di­ol­o­gy train­ing for PCPs at car­diac cen­ters and pro­vid­ing them with direct con­tact details of spe­cial­ists.

Enable car­di­ol­o­gists to access remote sup­port via vir­tu­al hos­pi­tals that gives them the capa­bil­i­ty to eval­u­ate a car­diac com­put­ed tomog­ra­phy (CT) scan and set up a suit­able treat­ment plan, includ­ing aware­ness of three-dimen­sion­al (3D) mod­el print­ing ser­vices, if need­ed, for chal­leng­ing TAVI cas­es.

Improve acces­si­bil­i­ty by estab­lish­ing satel­lite diag­nos­tic facil­i­ties and mobile screen­ing units. Pub­lic screen­ing cam­paigns will improve dis­ease aware­ness and diag­no­sis rates, and pro­vide valu­able epi­demi­o­log­i­cal data.

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Improve dis­ease man­age­ment

This can be done by devel­op­ing clin­i­cal guide­lines for VHD diag­no­sis and treat­ment, and by train­ing more HCPs in VHD care.

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Improve dis­ease man­age­ment

Estab­lish a clear work­force plan to ensure that the right skills and resources are avail­able at each lev­el of the health sys­tem. The plan must iden­ti­fy the type and quan­ti­ty of need­ed resources, which are to be com­mu­ni­cat­ed to health care providers and deci­sion-mak­ers.

Ensure prompt access to treat­ment and fol­low-up care after diag­no­sis by estab­lish­ing clear care path­ways and mon­i­tor­ing sys­tems. This enables appro­pri­ate ongo­ing man­age­ment. Ensure that HCPs in sec­ondary care have access to the appro­pri­ate tech­nolo­gies and equip­ment to pro­vide the sup­port need­ed.

Lever­age dig­i­tal plat­forms and sys­tems to enable reg­u­lar patient fol­low-ups and improve care coor­di­na­tion. Dig­i­tal plat­forms can be used to send screen­ing reminders, ensure reg­u­lar fol­low-ups and enable remote mon­i­tor­ing. Cen­tral­ized patient records and dig­i­tal infor­ma­tion shar­ing will also improve care by facil­i­tat­ing the track­ing of symp­toms and coor­di­na­tion between providers.

Imple­ment inte­grat­ed, mul­ti­dis­ci­pli­nary care teams to pro­vide com­pre­hen­sive care for patients. Col­lab­o­ra­tion between spe­cial­ists and across all lev­els of care enhances diag­no­sis accu­ra­cy, refines inter­ven­tions, and pro­vides con­tin­u­ous, well-round­ed care.

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Con­clu­sion

Degen­er­a­tive VHD is a seri­ous and grow­ing health con­cern in Sau­di Arabia’s pop­u­la­tion as it ages, but it is treat­able and pre­ventable. We must do more to raise aware­ness of VHD, diag­nose it ear­ly, and pro­vide treat­ment to those need­ing it. Address­ing the needs of an aging pop­u­la­tion aligns with Sau­di Vision 2030’s goal of improv­ing health care and cre­at­ing a health­i­er soci­ety.

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