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Randomized Controlled Trial
. 2020 Jan 23;15(1):e0226398.
doi: 10.1371/journal.pone.0226398. eCollection 2020.

A primary healthcare information intervention for communicating cardiovascular risk to patients with poorly controlled hypertension: The Education and Coronary Risk Evaluation (Educore) study-A pragmatic, cluster-randomized trial

Esperanza Escortell-Mayor  1   2 , Isabel Del Cura-González  1   2   3 , Elena Ojeda-Ruiz  4 , Teresa Sanz-Cuesta  1   2 , Isidro Rodríguez-Salceda  5 , Jesús García-Soltero  6 , María-José Rojas-Giraldo  7 , Pedro Herrera-Municio  6 , Alicia Jorge-Formariz  5 , Ángela Lorenzo-Lobato  8 , Luisa Cabello-Ballesteros  9 , Rosario Riesgo-Fuertes  2   10 , Sofía Garrido-Elustondo  2   11 , Mariel Morey-Montalvo  1   2   12 , Milagros Rico-Blázquez  1   2 , Ricardo Rodríguez-Barrientos  1   2 , María-Dolores Fuente-Arriaran  13 , Gloria Sierra-Ocaña  14 , Encarnación Serrano-Serrano  15 , Carmelina Sanz-Velasco  13 , Roberto Carrascoso-Calvo  5 , Juan Carlos Recio-Velasco  16 , Marta Sanz-Sanz  17 , Mercedes Rumayor-Zarzuelo  18 , Olga-Inés Bermejo-Mayoral  5 , Josefina Galán-Esteban  6 , Antonio Sarría-Santamera  2   19   20 ; Educore Group
Affiliations
Randomized Controlled Trial

A primary healthcare information intervention for communicating cardiovascular risk to patients with poorly controlled hypertension: The Education and Coronary Risk Evaluation (Educore) study-A pragmatic, cluster-randomized trial

Esperanza Escortell-Mayor et al. PLoS One. .

Abstract

Purpose: Uncertainty exists regarding the best way to communicate cardiovascular risk (CVR) to patients, and it is unclear whether the comprehension and perception of CVR varies according to the format used. The aim of the present work was to determine whether a strategy designed for communicating CVR information to patients with poorly controlled high blood pressure (HBP), but with no background of cardiovascular disease, was more effective than usual care in the control of blood pressure (BP) over the course of a year.

Methods: A pragmatic, two-arm, cluster-randomized controlled trial was performed. Consecutive patients aged 40-65 years, all diagnosed with HBP in the last 12 months, and all of whom showed poor control of their condition (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg), were recruited at 22 primary healthcare centres. Eleven centres were randomly assigned to the usual care arm, and 11 to the informative intervention arm (Educore arm). At the start of the study, the Educore arm subjects were shown the "low risk SCORE table", along with impacting images and information pamphlets encouraging the maintenance of good cardiovascular health. The main outcome variable measured was the control of HBP; the secondary outcome variables were SCORE table score, total plasma cholesterol concentration, use of tobacco, adherence to prescribed treatment, and quality of life.

Results: The study participants were 411 patients (185 in the Educore arm and 226 in the usual care arm). Multilevel logistic regression showed that, at 12 months, the Educore intervention achieved better control of HBP (OR = 1.57; 1.02 to 2.41). No statistically significant differences were seen between the two arms at 12 months with respect to the secondary outcomes.

Conclusions: Compared to usual care, the Educore intervention was associated with better control of HBP after adjusting for age, baseline SBP and plasma cholesterol, at 12 months.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Graphical depiction of Educore intervention vs usual care.
Fig 2
Fig 2. Study flow diagram.
See this image and copyright information in PMC

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