Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013:9:13-20.
doi: 10.2147/VHRM.S39919. Epub 2013 Feb 13.

Effectiveness of a quality improvement intervention targeting cardiovascular risk factors: are patients responsive to information and encouragement by mail or post?

Ellie Senesael  1 , Liesbeth Borgermans, Erwin Van De Vijver, Dirk Devroey
Affiliations
Randomized Controlled Trial

Effectiveness of a quality improvement intervention targeting cardiovascular risk factors: are patients responsive to information and encouragement by mail or post?

Ellie Senesael et al. Vasc Health Risk Manag. 2013.

Abstract

Introduction: There is important evidence on the beneficial effects of treatment of cardiovascular risk factors in terms of morbidity and mortality, but important challenges remain in motivating patients to adhere to their treatment regimen. This study aimed to describe the effectiveness of a quality improvement intervention that included information and regular encouragement by email or letter on cardiovascular risk factors for patients at high risk for cardiovascular disease.

Methods: This randomized single-blind study included patients of both sexes aged between 45 and 80 years old who had increased cardiovascular risk. Patients were randomly allocated to either a usual care group (UCG) or advanced care group (ACG). Patients in the UCG received regular care while patients in the ACG received usual care plus regular information and encouragement on cardiovascular risk factors by email or letter. Visits for both groups were planned at 0, 3, and 6 months. The outcome measures were blood pressure, weight, body mass index (BMI), waist circumference (WC), and smoking status.

Results: Out of 178 eligible patients from one single primary care practice, 55 participated in the study, three of whom dropped out. After 6 months, there was a significant decrease in mean systolic and diastolic blood pressure in the UCG and ACG (P < 0.05). The decreases were already significant after 3 months, except for systolic blood pressure in the UCG. There was also a significant increase in the proportion of patients who met the target values for blood pressure in the UCG and ACG. There was a nonsignificant decrease of the average weight in the ACG, but significantly more patients lost weight in the UCG (P = 0.02). BMI, WC, and smoking status did not change in either group.

Conclusion: This study found that there was a significant decrease of systolic and diastolic blood pressure in both study groups. Weight, BMI, WC, and smoking did not improve in either group. Information on cardiovascular risk factors and encouragement by means of letters or email did not provide additional benefits. Thus, effective patient empowerment probably requires more behaviorally sophisticated support to increase self-management, self-efficacy, and self-esteem in patients.

Keywords: cardiovascular risk; family medicine; lifestyle; tele-health.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Evolution of the average systolic blood pressure in both groups at month 0, 3, and 6.
Figure 2
Figure 2
Evolution of the average diastolic blood pressure in both groups at month 0, 3, and 6.
See this image and copyright information in PMC

References

    1. Lloyd-Williams F, O’Flaherty M, Mwatsama M, Birt C, Ireland R, Capewell S. Estimating the cardiovascular mortality burden attributable to the European Common agricultural policy on dietary saturated fats. Bull World Health Organ. 2008;86(7):497–576. - PMC - PubMed
    1. Banegas JR, López-García E, Dallongeville J, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J. 2011;32(17):2143–2152. - PMC - PubMed
    1. Graham I, Atar D, Borch-Johnsen K, et al. European Society of Cardiology (ESC); European Association for Cardiovascular Prevention and Rehabilitation (EACPR); Council on Cardiovascular Nursing; European Association for Study of Diabetes (EASD); International Diabetes Federation Europe (IDF-Europe); European Stroke Initiative (EUSI); Society of Behavioural Medicine (ISBM); European Society of Hypertension (ESH); WONCA Europe (European Society of General Practice/Family Medicine); European Heart Network (EHN); European Atherosclerosis Society (EAS) European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) Eur J Cardiovasc Prev Rehabil. 2007;14( Suppl 2):S1–S113. - PubMed
    1. Robroek SJ, Bredt FJ, Burdorf A. The (cost-)effectiveness of an individually tailored long-term worksite health promotion programme on physical activity and nutrition: design of a pragmatic cluster randomised controlled trial. BMC Public Health. 2007;7:259. - PMC - PubMed
    1. Romdhane HB, Damesceno A, Ebraham S, et al. Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Cardiovascular Risk. Geneva: World Health Organisation; 2007. [Accessed December 29, 2012]. Available from: http://whqlibdoc.who.int/publications/2007/9789241547178_eng.pdf.

Publication types

MeSH terms

LinkOut - more resources