RT Journal Article
SR Electronic
T1 Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E267
OP E274
DO 10.1503/cmaj.081591
VO 181
IS 12
A1 Marije S. Koelewijn-van Loon
A1 Trudy van der Weijden
A1 Ben van Steenkiste
A1 Gaby Ronda
A1 Bjorn Winkens
A1 Johan L. Severens
A1 Michel Wensing
A1 Glyn Elwyn
A1 Richard Grol
YR 2009
UL http://www.cmaj.ca/content/181/12/E267.abstract
AB 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.