Vrije Universiteit Brussel


Senesael E, Borgermans L, Van De Vijver E, Devroey D. Effectiveness of a quality improvement intervention targeting cardiovascular risk factors: Are patients responsive to information and encouragement by mail or post? Vasc Health Risk Manag. 2013;9:13-20.

Eerste auteur: Senesael E.

Jaar: 2013

Type: Publicatie

Medline

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Vasc Health Risk Manag.

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. The aim of this study was to describe the effectiveness of a quality improvement intervention including information and regular encouragements by e-mail or letter on cardiovascular risk factors for patients with a high risk for cardiovascular disease.

Methods
This randomised single-blind study included patients of both sexes aged between 45 and 80 years who had an increased cardiovascular risk. Patients were randomly allocated to a ‘Usual Care Group’ (UCG) or ‘Advanced Care Group’ (ACG). Patients in the UCG received regular care whilst patients in the ACG received usual care plus regular information and encouragement on cardiovascular risk factors by e-mail 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
55 out of 178 eligible patients from one single primary care practice participated in the study, and 3 patients dropped out. After six months there was a significant decrease in mean systolic and diastolic blood pressure in UCG and ACG (p <0.05). There was also a significant increase in the proportion of patients who met the target values for blood pressure in UCG and ACG. There was a non-significant decrease of the average weight in ACG, but significantly more patients lost weight in the UCG (p = 0.02). BMI did not change in both groups. The average WC did not decrease significantly (-2.9 cm; p=0.5). There was no significant change in the proportion of participants that reached the targets for BMI and WC neither did change the smoking status in UCG and ACG.

Conclusions
This study reveals a significant decrease of systolic and diastolic blood pressure in both study groups. Weight, BMI, waist circumference and smoking did not improve.
Information and encouragements on cardiovascular risk factors by means of letters or emails did not provide additional benefits. Effective patient empowerment probably requires more behaviourally sophisticated support to increase self-management, self-efficacy and self-esteem in patients.

Trefwoorden: Cardiovascular risk, tele-health, lifestyle, family medicine

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