Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial

Koelewijn-van Loon, Marije S.; van der Weijden, Trudy; van Steenkiste, Ben; Ronda, Gaby; Winkens, Bjorn; Severens, Johan L.; Wensing, Michel; Elwyn, Glyn; Grol, Richard
December 2009
CMAJ: Canadian Medical Association Journal;12/8/2009, Vol. 181 Issue 12, pE267
Academic Journal
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.


Related Articles

  • The Influence of User Characteristics and a Periodic Email Prompt on Exposure to an Internet-Delivered Computer-Tailored Lifestyle Program. Schneider, Francine; van Osch, Liesbeth; Schulz, Daniela N.; Kremers, Stef P. J.; de Vries, Hein // Journal of Medical Internet Research;Mar/Apr2012, Vol. 14 Issue 2, p18 

    Background: The Internet is a promising medium in the field of health promotion for offering tailored and targeted lifestyle interventions applying computer-tailored (CT) techniques to the general public. Actual exposure to CT interventions is not living up to its high expectations, as only a...

  • The consequential costs related to lifestyle. Greenshields, Gordon // British Journal of Healthcare Management;Mar2014, Vol. 20 Issue 3, p115 

    There are enormous consequential costs to the NHS in treating ill-health where lifestyle self-abuse behaviour regarding diet, exercise, smoking and alcohol consumption are key factors. H The statistical trends of these risk factors, particularly in obesity/overweight and alcohol consumption,...

  • Association of Socioeconomic Position With Health Behaviors and Mortality. Stringhini, Silvia; Sabia, Severine; Shipley, Martin; Brunner, Eric; Nabi, Hermann; Kivimaki, Mika; Singh-Manoux, Archana // JAMA: Journal of the American Medical Association;3/24/2010, Vol. 303 Issue 12, p1159 

    The article focuses on a study which assessed the influence of health behaviors on the link between socioeconomic status and mortality. The study included 10,308 civil servants, aged 35 to 55 years, who were examined based on smoking and alcohol consumption, diet and physical activity. It...

  • Globalization of Diabetes. HU, FRANK B. // Diabetes Care;Jun2011, Vol. 34 Issue 6, p1249 

    The article considers type 2 diabetes as a global public health crisis which threatens the health and economy of all countries. Contributing factors to type 2 diabetes are obesity and fat distribution, diet, physical activity, smoking, and alcohol use. The advances of genome-wide association...

  • Physical Activity and Blood Lipids and Lipoproteins in Dialysis Patients. Hiroyuki Imamura; Keiko Mizuuchi; Reika Oshikata // International Journal of Nephrology;2012, p1 

    The relationship between physical activity and blood lipids and lipoproteins in dialysis patients is reviewed in the context of the potentially confounding factors such as nutritional intake, cigarette smoking, obesity, alcohol intake, and physical activity levels in the general population and...

  • Never Too Late.  // Nutrition Action Health Letter;Nov2004, Vol. 31 Issue 9, p11 

    Provides information on the effect of eating a healthy Mediterranean diet, exercising and drinking alcohol moderately on the health of European people based on a study conducted. Food being eaten by those people who received the highest diet scores from researchers; Percentage of the people...

  • Cross-Sectional Associations between Multiple Lifestyle Behaviors and Health-Related Quality of Life in the 10,000 Steps Cohort. Duncan, Mitch J.; Kline, Christopher E.; Vandelanotte, Corneel; Sargent, Charli; Rogers, Naomi L.; Di Milia, Lee // PLoS ONE;Apr2014, Vol. 9 Issue 4, p1 

    Background: The independent and combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration and quality on health status is not routinely examined. This study investigates the relationships between these lifestyle behaviors, independently and in...

  • Brief motivational counselling does not reduce alcohol consumption in people with high alcohol intake. Stewart, Scott H. // Evidence Based Mental Health;Nov2007, Vol. 10 Issue 4, p119 

    The article examines whether a brief motivational counseling session improve alcohol outcomes in hospitalized patients with unhealthy alcohol use. It shows that a single brief session of motivational counseling does not reduce alcohol consumption by 12 months, or the need for assistance for...

  • PACT to help women stop drinking during pregnancy.  // Midwifery News;Dec2012, Issue 67, p44 

    The article reports the development of Pregnancy Alcohol Cessation Toolkit (PACT), an online course on health promotion initiatives to control alcohol consumption among pregnant women for midwives to acquire certification.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics