Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care
- Ans H TiessenAffiliated withDepartment General Practice, University Medical Centre Email author
- , Andries J SmitAffiliated withDepartment Internal Medicine, University Medical Centre
- , Jan BroerAffiliated withMunicipal Public Health Service Groningen
- , Klaas H GroenierAffiliated withDepartment General Practice, University Medical Centre
- , Klaas van der MeerAffiliated withDepartment General Practice, University Medical Centre
Treatment goals for cardiovascular risk management are generally not achieved. Specialized practice nurses are increasingly facilitating the work of general practitioners and self-monitoring devices have been developed as counseling aid. The aim of this study was to compare standard treatment supported by self-monitoring with standard treatment without self-monitoring, both conducted by practice nurses, on cardiovascular risk and separate risk factors.
Men aged 50–75 years and women aged 55–75 years without a history of cardiovascular disease or diabetes, but with a SCORE 10-year risk of cardiovascular mortality ≥5% and at least one treatable risk factor (smoking, hypertension, lack of physical activity or overweight), were randomized into two groups. The control group received standard treatment according to guidelines, the intervention group additionally received pro-active counseling and self-monitoring (pedometer, weighing scale and/ or blood pressure device). After one year treatment effect on 179 participants was analyzed.
SCORE risk assessment decreased 1.6% (95% CI 1.0–2.2) for the control group and 1.8% (1.2–2.4) for the intervention group, difference between groups was .2% (−.6–1.1). Most risk factors tended to improve in both groups. The number of visits was higher and visits took more time in the intervention group (4.9 (SD2.2) vs. 2.6 (SD1.5) visits p < .001 and 27 (P25 –P75:20–33) vs. 23 (P25 –P75:19–30) minutes/visit p = .048).
In both groups cardiovascular risk decreased significantly after one year of treatment by practice nurses. No additional effect of basing the pro-active counseling on self-monitoring was found, despite the extra time investment.
KeywordsPrimary health care Arteriosclerosis Cardiovascular diseases Prevention and control Self-management Risk factors
- Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BMC Family Practice
- Online Date
- September 2012
- Online ISSN
- BioMed Central
- Additional Links
- Primary health care
- Cardiovascular diseases
- Prevention and control
- Risk factors
- Author Affiliations
- 1. Department General Practice, University Medical Centre, Groningen, the Netherlands
- 2. Department Internal Medicine, University Medical Centre, Groningen, the Netherlands
- 3. Municipal Public Health Service Groningen, Groningen, the Netherlands