Close Menu

Screening for Non-communicable Diseases at a Walk-in Clinic in Trinidad, West Indies: A Time-motion Cross-sectional Study and Net Present Value Analysis



Objective: The overall aim of this study was to determine the feasibility of recommending a screening process for non-communicable diseases (NCDs) and their risk factors, as a national and regional model.

Methods: A cross-sectional, six-station process was carried out. It consisted of the invitation and consent, history (personal and family history of NCDs), biometrics (waist circumference, BMI), blood levels (lipids and HbA1c) and urinalysis (microalbuminuria), basic examinations (BP, peripheral neuropathy, presence of acanthosis nigricans and visual acuity) and an exit interview of the participants. Net Present Value (NPV) calculations were carried out for very the high risk patients (defined as a > 30% risk of a cardiovascular event (limb amputation) in the next ten years) for two discount rates of 0.75% (US) and 3.4% (Trinidad and Tobago).

Results: A convenience sample of 514 walk-in patients (56.2% recruitment rate) was screened, ~23 patients per day. The median time for a patient attending all the stations was 21 minutes (Range 11-59 minutes). Of the six stations, the laboratory was the lengthiest, median 10 minutes (Range 2-50 minutes). The entire project cost USD $20 439 (USD $39.76 per patient). Between one and seven very high risk patients (three sub-groups of patients had this risk profile) were identified. The cost of identifying a very high risk patient ranged from USD $2907 to USD $20 349. The NPV of identifying these high risk patients ranged from -$6748 to $14 725 and was favourable for three of the four monetary scenarios.

Conclusion: A six-station process to provide rapid screening of walk-in patients for NCDs is feasible and provides monetary value in three of the four scenarios in a Caribbean setting. 

03 Jan, 2017
05 Dec, 2016
e-Published: 12 Jan, 2017

Pre-published Manuscript

This manuscript has been assigned to a volume and issue but has not yet been published. It is either being edited, typeset or is in the proof stage of publication.
In the pre-published stage, this manuscript may contain statements, opinions, and information that have errors in facts, figures, or interpretation. Any final changes in this manuscript will be made at the time of publication and will be reflected in the final electronic version of the issue. The editors and authors and their respective employees are not responsible or liable for the use of any such inaccurate or misleading data, opinion or information contained in the articles in this section.

Become a subscriber to access the full article.

Top of Page