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More data, better data or improved evidence translation: what will improve cardiovascular outcomes? As countries must focus more on the value of and access to health services over effectiveness alone, we argue that data on key aspects of interventions are predominantly missing from the current evidence-base. We examine this need in relation to secondary prevention of the most burdensome disease in the world: coronary heart disease and consider the wider forms of evidence about interventions needed by professionals, systems and governments to promote effective, accessible and efficient chronic disease management.

Online food delivery usage has soared during the 2019 novel coronavirus (COVID-19) pandemic which has seen increased demand for home-delivery during government mandated stay-at-home periods. Resulting implications from COVID-19 may threaten decades of development gains. It is becoming increasingly more important for the global community to progress toward sustainable development and improve the wellbeing of people, economies, societies, and the planet. In this perspective article, we discuss how the rising use of these platform-to-consumer delivery operations may impede advances toward the United Nations 2030 Sustainable Development Goals (SDGs). Specifically, online food delivery services may disrupt SDGs that address good health and wellbeing, responsible consumption and production, climate action and decent work and economic growth. To mitigate potential negative impacts of these meal delivery apps, we have proposed a research and policy agenda that is aligned with entry points within a systems approach identified by the World Health Organization. Food industry reforms, synergised public health messaging and continuous monitoring of the growing impact of online food delivery should be considered for further investigation by researchers, food industry, governments, and policy makers.

BACKGROUND: Government-subsidised general practice management plans (GPMPs) facilitate chronic disease management; however, impact on cardiovascular disease (CVD) is unknown. We aimed to determine utilisation and impact of GPMPs for people with or at elevated risk of CVD. METHODS: Secondary analysis of baseline data from the CONNECT randomised controlled trial linked to Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) claims. Multivariate regression examining the association of GPMP receipt and review with: (1) ≥ 1 MBS-subsidised allied health visit in the previous 24 months; (2) adherence to dual cardioprotective medication (≥ 80% of days covered with a dispensed PBS prescription); and (3) meeting recommended LDL-cholesterol and blood pressure (BP) targets concurrently. RESULTS: Overall, 905 trial participants from 24 primary health care services consented to data linkage. Participants with a GPMP (46.6%, 422/905) were older (69.4 vs 66.0 years), had lower education (32.3% vs 24.7% high school or lower), lower household income (27.5% vs 17.0% in lowest bracket), and more comorbidities, particularly diabetes (42.2% vs 17.6%) compared to those without a GPMP. After adjustment, a GPMP was strongly associated with allied health visits (odds ratio (OR) 14.80, 95% CI: 9.08–24.11) but not higher medication adherence rates (OR 0.82, 95% CI: 0.52–1.29) nor meeting combined LDL and BP targets (OR 1.31, 95% CI: 0.72–2.38). Minor differences in significant covariates were noted in models using GPMP review versus GPMP initiation. CONCLUSIONS: In people with or at elevated risk of CVD, GPMPs are under-utilised overall. They are targeting high-needs populations and facilitate allied health access, but are not associated with improved CVD risk management, which represents an opportunity for enhancing their value in supporting guideline-recommended care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-022-01763-2.

BACKGROUND: Widespread access to good quality antihypertensive medicines is a critical component for reducing premature cardiovascular disease (CVD) mortality. Poor-quality medicines pose serious health concerns; however, there remains a knowledge gap about the quality of cardiovascular medicines available in low- and middle-income countries. OBJECTIVES: The aim of this study was to determine the quality of generic antihypertensive medicines available in the retail market of a developing country. METHODS: Samples of the 2 most commonly prescribed classes of antihypertensive medicines were collected from 3 states in 3 different geopolitical zones in Nigeria following a semirandom sampling framework. Medicine samples were purchased by mystery shoppers from 22 pharmacy outlets from 6 local government areas across the 3 states. Medicine quality was determined by measuring the amount of stated active pharmaceutical ingredient using high-performance liquid chromatography with photodiode array detection and classified according to their compliance to the specified pharmacopeia tolerance limits for each antihypertensive drug. RESULTS: Amlodipine and lisinopril were identified as the most commonly prescribed antihypertensive drugs in Nigeria. In total, 361 samples from 22 pharmacies were collected and tested. In total, 24.6% of amlodipine and 31.9% of lisinopril samples were of substandard quality and significantly more samples purchased in rural (59 of 161, 36.7%) compared with urban (32 of 200, 16%) outlets were found to be of substandard quality (p < 0.001). No falsified samples of either amlodipine or lisinopril were detected. There was large variation in price paid for the antihypertensive medicines (range ₦150 to ₦9,750). Of the 24 pharmacy outlets surveyed, 46% stated that patients did not always require a prescription and 21% had previously reported a medicine as falsified or substandard. CONCLUSIONS: More than one-quarter of some commonly prescribed antihypertensive medicines available in Nigeria may be of substandard quality. Enhanced quality assurance processes in low- and middle-income countries, such as Nigeria, are needed to support optimum management.

To evaluate the digital platforms most used by adolescents for healthy lifestyle information, perceived helpfulness of platform information, helpfulness for positive behaviour changes, and quality of platforms' lifestyle health information. Mixed-methods study including a cross-sectional online survey and content analysis. Eligible participants were 13–18-years; living in Australia; and had searched online for healthy lifestyle behaviour (nutrition, physical activity, weight management, sleep) information in the previous three months. Survey items examined the use of digital platforms, self-perceived helpfulness, usefulness for positive behaviour, and popular content. Data were analysed using descriptive statistics and ordinal logistic regression models. Content analysis was performed on popular digital content to evaluate expertise, objectivity, transparency, popularity, and relevance. In total, 297 participants completed the survey (62.3% female; 15.8 [SD1.5] years). Seventy-eight percent and 77% of participants reported using websites and social media, respectively, for seeking healthy lifestyle information. Websites and social media were rated as somewhat helpful by 43% and 46% of participants, respectively. Sixty-six percent and 53% of participants agreed/strongly agreed smartphone apps and social media were helpful for positive behaviour change, respectively. Helpfulness did not differ by age or gender. We evaluated 582 popular digital content; 38% were produced by a commercial company. Only 7% of content was from health organisations, 10% from health professionals and only 10% of content was objective, and 14% was transparent. Adolescents extensively utilise websites and social media for health information, yet popular content has limited objectivity and transparency. Governments and health organisations should consider creating age-appropriate digital information for healthy lifestyle behaviours.

To evaluate the digital platforms most used by adolescents for healthy lifestyle information, perceived helpfulness of platform information, helpfulness for positive behaviour changes, and quality of platforms' lifestyle health information. Mixed-methods study including a cross-sectional online survey and content analysis. Eligible participants were 13–18-years; living in Australia; and had searched online for healthy lifestyle behaviour (nutrition, physical activity, weight management, sleep) information in the previous three months. Survey items examined the use of digital platforms, self-perceived helpfulness, usefulness for positive behaviour, and popular content. Data were analysed using descriptive statistics and ordinal logistic regression models. Content analysis was performed on popular digital content to evaluate expertise, objectivity, transparency, popularity, and relevance. In total, 297 participants completed the survey (62.3% female; 15.8 [SD1.5] years). Seventy-eight percent and 77% of participants reported using websites and social media, respectively, for seeking healthy lifestyle information. Websites and social media were rated as somewhat helpful by 43% and 46% of participants, respectively. Sixty-six percent and 53% of participants agreed/strongly agreed smartphone apps and social media were helpful for positive behaviour change, respectively. Helpfulness did not differ by age or gender. We evaluated 582 popular digital content; 38% were produced by a commercial company. Only 7% of content was from health organisations, 10% from health professionals and only 10% of content was objective, and 14% was transparent. Adolescents extensively utilise websites and social media for health information, yet popular content has limited objectivity and transparency. Governments and health organisations should consider creating age-appropriate digital information for healthy lifestyle behaviours.

Background: Widespread access to good quality antihypertensive medicines is a critical component for reducing premature cardiovascular disease (CVD) mortality. Poor-quality medicines pose serious health concerns; however, there remains a knowledge gap about the quality of cardiovascular medicines available in low- and middle-income countries.Objectives: The aim of this study was to determine the quality of generic antihypertensive medicines available in the retail market of a developing country.Methods: Samples of the 2 most commonly prescribed classes of antihypertensive medicines were collected from 3 states in 3 different geopolitical zones in Nigeria following a semirandom sampling framework. Medicine samples were purchased by mystery shoppers from 22 pharmacy outlets from 6 local government areas across the 3 states. Medicine quality was determined by measuring the amount of stated active pharmaceutical ingredient using high-performance liquid chromatography with photodiode array detection and classified according to their compliance to the specified pharmacopeia tolerance limits for each antihypertensive drug.Results: Amlodipine and lisinopril were identified as the most commonly prescribed antihypertensive drugs in Nigeria. In total, 361 samples from 22 pharmacies were collected and tested. In total, 24.6% of amlodipine and 31.9% of lisinopril samples were of substandard quality and significantly more samples purchased in rural (59 of 161, 36.7%) compared with urban (32 of 200, 16%) outlets were found to be of substandard quality (p < 0.001). No falsified samples of either amlodipine or lisinopril were detected. There was large variation in price paid for the antihypertensive medicines (range ₦150 to ₦9,750). Of the 24 pharmacy outlets surveyed, 46% stated that patients did not always require a prescription and 21% had previously reported a medicine as falsified or substandard.Conclusions: More than one-quarter of some commonly prescribed antihypertensive medicines available in Nigeria may be of substandard quality. Enhanced quality assurance processes in low- and middle-income countries, such as Nigeria, are needed to support optimum management.HighlightsManagement of hypertension can largely be achieved through availability of and adherence to qualitative evidence-based medicines. There is very little research examining the quality of antihypertensive medicines available in the retail market of low- and middle-income countries.In total, 361 samples of amlodipine and lisinopril were collected from 22 pharmacies and their stated active pharmaceutical ingredient was measured.More than a quarter of some commonly prescribed antihypertensive medicines available in Nigeria appear to be of substandard quality (samples had more or less stated active pharmaceutical ingredient than stated in the United States Pharmacopeia–specified tolerance limits range).However, the proportion of substandard quality was not statistically different for amlodipine and lisinopril, and significantly more samples purchased in rural compared with urban outlets were of substandard quality.No falsified samples (containing no stated active pharmaceutical ingredient) of either amlodipine or lisinopril were detected.Enhanced quality assurance processes in low- and middle-income countries such as Nigeria are needed to support optimum management.