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Randomized Controlled Trial
. 2009 Dec 8;181(12):E267-74.
doi: 10.1503/cmaj.081591. Epub 2009 Nov 30.

Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial

Marije S Koelewijn-van Loon  1 , Trudy van der Weijden, Ben van Steenkiste, Gaby Ronda, Bjorn Winkens, Johan L Severens, Michel Wensing, Glyn Elwyn, Richard Grol
Affiliations
Randomized Controlled Trial

Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial

Marije S Koelewijn-van Loon et al. CMAJ. .

Abstract

Background: Preventive guidelines on cardiovascular risk management recommend lifestyle changes. Support for lifestyle changes may be a useful task for practice nurses, but the effect of such interventions in primary prevention is not clear. We examined the effect of involving patients in nurse-led cardiovascular risk management on lifestyle adherence and cardiovascular risk.

Methods: We performed a cluster randomized controlled trial in 25 practices that included 615 patients. The intervention consisted of nurse-led cardiovascular risk management, including risk assessment, risk communication, a decision aid and adapted motivational interviewing. The control group received a minimal nurse-led intervention. The self-reported outcome measures at one year were smoking, alcohol use, diet and physical activity. Nurses assessed 10-year cardiovascular mortality risk after one year.

Results: There were no significant differences between the intervention groups. The effect of the intervention on the consumption of vegetables and physical activity was small, and some differences were only significant for subgroups. The effects of the intervention on the intake of fat, fruit and alcohol and smoking were not significant. We found no effect between the groups for cardiovascular 10-year risk.

Interpretation: Nurse-led risk communication, use of a decision aid and adapted motivational interviewing did not lead to relevant differences between the groups in terms of lifestyle changes or cardiovascular risk, despite significant within-group differences.

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Figures

Figure 1
Figure 1
Flow diagram of the progress of clusters and individuals through the phases of the trial.
Figure 2
Figure 2
Multilevel logistic regression analysis of smoking (n = 114) and alcohol use (n = 48) at 1 year. Note: CI = confidence interval, ICC = intraclass correlation coefficient.
See this image and copyright information in PMC

References

    1. Jolliffe JA, Rees K, Taylor RS, et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2001;(1):CD001800. - PubMed
    1. Ades PA, Pashkow FJ, Nestor JR. Cost-effectiveness of cardiac rehabilitation after myocardial infarction. J Cardiopulm Rehabil. 1997;17:222–31. - PubMed
    1. van Berkel TF, Boersma H, Roos Hesselink JW, et al. Impact of smoking cessation and smoking interventions in patients with coronary heart disease. Eur Heart J. 1999;20:1773–82. - PubMed
    1. Ebrahim S, Beswick A, Burke M, et al. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev. 2006;(4):CD001561. - PMC - PubMed
    1. Hooper L, Summerbell CD, Higgins JP, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2001;(3):CD002137. - PubMed

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