A cluster randomised controlled trial of vascular risk factor management in general practice

Harris, Mark; Fanaian, Mahnaz; Jayasinghe, Upali W; Passey, Megan; McKenzie, Suzanne; Davies, Gawaine Powell; Lyle, David; Laws, Rachel; Schütze, Heike; Wan, Qing

doi:10.5694/mja12.10313

Cited by 31 publications

(60 citation statements)

References 18 publications

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“…Similarly, in a cluster randomized controlled trial, Harris MF et al [42], found a small weight reduction (1.06 kg) that was achieved only among those attending the intervention group, participating in the education program. Improved glycemic control reduced microvascular and macrovascular complications associated with type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 98%

Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial

Kuhmmer

Lazzaretti

Guterres

et al. 2016

BMC Health Serv Res

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BackgroundHypertension is a public health problem and a major risk factor for cardiovascular disease. The purpose of this study is to compare the effectiveness of a multidisciplinary program based on group and individual care versus group-only care, to promote blood pressure control in hypertensive patients in primary health care.MethodsRandomized controlled clinical trial. The study was conducted within the primary health care, in two units of the Family Health Strategy, covering 11,000 individuals, in Porto Alegre, Brazil. Two hundred and 56 patients, older than 40 years old and with uncontrolled hypertension, systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg or ≥130 mmHg and/or diastolic BP ≥80 mmHg for individuals with diabetes. Eligible patients were randomly assigned to a health care program aiming for blood pressure control, with the multidisciplinary program group or with the multidisciplinary program plus personalized care group. Primary outcome measures were reduction in systolic BP from baseline to 6 months. Secondary measures included proportion of patients with systolic or diastolic BP controlled. Student t test, Pearson’s chi-squared test, Fisher’s exact test, Mann-Whitney U test, Wilcoxon signed-ranks test and generalized estimating equation (GEE) model were used in the analysis.ResultsThe baseline characteristics of participants were similar between groups. After 6 months of follow-up, systolic BP decreased markedly in both groups (Δ - 11.8 mmHg [SD, 20.2] in the multidisciplinary program group and Δ - 12.9 mmHg [SD, 19.2] in the personalized care group; p < 0.001). Similarly, we noted a significant change in diastolic BP over time in both groups (Δ - 8.1 mmHg [SD, 10.8] in the multidisciplinary program group and Δ - 7.0 mmHg [SD, 11.5] in the personalized care group; p < 0.001).ConclusionsThe study demonstrates similar effectiveness of a group intervention in comparison to a personalized education program in hypertension patients to achieve BP control. These findings indicate that the intervention can be for all hypertensive patients assisted in primary health care.Trial registrationClinicalTrials.gov IdentifierNCT01696318 (May 2013).

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Section: Discussionmentioning

confidence: 98%

Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial

Kuhmmer

Lazzaretti

Guterres

et al. 2016

BMC Health Serv Res

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“…[40][41][42] These studies found that they could improve referral rates through good linkages with referral services, a referral system, and structured interventions free of participation fees. The HUC implementation strategy met those conditions, with the exception of the referral system.…”

Section: Findings Compared To Those In the Literaturementioning

confidence: 99%

Process Evaluation of the Nationwide Implementation of a Lifestyle Intervention in the Construction Industry

Tonnon

Proper²,

Ploeg³

et al. 2016

Journal of Occupational &Amp; Environmental Medicine

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“…940–944 Other strategies focus on changing the organization or context in which the care is delivered, including delegation of preventive services to nonphysician staff (eg, nurses or pharmacists), the use of group visits, or the implementation of clinics devoted to screening and preventive services. 943,945–948 Quality improvement efforts that include activities that focus on the system, the provider, and the patient, as well as the coordination of services across these domains, are often the most effective. 949 Studies examining the effectiveness of stroke education programs have generally identified a modest effect on patient knowledge, risk perception, or health beliefs.…”

Section: Strategies To Improve Preventive Vascular Health Servicesmentioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Meschia¹,

Bushnell²,

Boden‐Albala³

et al. 2014

Stroke

1,660

586

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The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of stroke among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances, including sickle cell disease and patent foramen ovale.

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A cluster randomised controlled trial of vascular risk factor management in general practice

Abstract: Australian New Zealand Clinical Trials Registry ACTRN12607000423415.

Cited by 31 publications

References 18 publications

Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial

Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial

Process Evaluation of the Nationwide Implementation of a Lifestyle Intervention in the Construction Industry

Guidelines for the Primary Prevention of Stroke

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