About Fellow

St John’s Medical College, Bengaluru

St John’s Medical College, Bengaluru

St John’s Medical College, Bengaluru

As a young medical student, I witnessed a large number of people from my community falling prey to ischemic heart disease and stroke, 2 diseases that we now know are preventable to a large extent. I also saw firsthand the enormous attendant socio-economic burdens imposed on families by these conditions. The Global Burden of Disease (GBD) study confirms that Ischemic Heart Disease causes the highest number of premature deaths and accounts for the highest number of Disability Adjusted Life Years (DALYs) lost in India.

 

We also live in an era of evidence based medicine, wherein evidence generated by well designed research informs the practice of medicine. I realised early on in my medical career that in South Asia, given the resource constraints, we need more evidence on cost-effective interventions to combat preventable non-communicable diseases, which is what inspired my research calling.

Studies performed globally, have increasingly drawn attention to what is called the ‘know-do’ gap, especially in cardiovascular disease. For instance, we know that there are a set of proven, effective, low cost medications that can be employed for the secondary prevention of ischemic heart disease. However, studies show large proportions of patients are non-adherent to these medications. Implementation research aims to bridge this know-do gap. My postgraduate training at St John’s Medical College gave me a grounding cardiovascular disease (CVD) epidemiology and implementation research. As a postgraduate, I had the opportunity to work on 2 large National Institutes of Health, USA (NIH) funded studies  - the first being a large nationwide stroke registry and the second, a task shifting project for improving secondary prevention of ischemic heart disease, under the guidance of Dr.Prem Pais and Dr.Denis Xavier, who are among the pioneers of CVD epidemiology in India. My fellowship project among heart failure patients is an implementation research project that combines training the patient or care-provider in self care, health worker based education and follow-up and technology to bridge the gap between patients and care providers. We hope that this intervention can reduce re-hospitalization and deaths among heart failure patients.