TY - JOUR
T1 - Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: A cluster-randomized controlled trial in primary care
AU - Koelewijn-van Loon, Marije S.
AU - van der Weijden, Trudy
AU - Ronda, Gaby
AU - van Steenkiste, Ben
AU - Winkens, Bjorn
AU - Elwyn, Glyn
AU - Grol, Richard P.
PY - 2010
Y1 - 2010
N2 - Objective. To determine if lifestyle improved at a short term through an intervention to involve patients in cardiovascular risk management by the practice nurse. Methods. The IMPALA study (2006, the Netherlands) was a cluster-randomised controlled trial involving 25 general practices and 615 patients who were eligible for cardiovascular risk management. The intervention consisted of (1) individual 10-year cardiovascular risk assessment, (2) risk communication, (3) use of a decision aid and (4) adapted motivational interviewing, applied by practice nurses in two consultations. Outcomes were smoking, alcohol, diet, physical activity and the secondary outcomes risk perception, anxiety, confidence about the decision and satisfaction with the communication, measured at baseline and after 12 weeks. Results. Patients of both groups improved their lifestyle, but no relevant significant differences between the groups were found. Intervention group patients improved in terms of the appropriateness of risk perception, although not significantly. Intervention group patients improved significantly in terms of appropriateness of anxiety and were more satisfied with the communication compared to control group patients. Conclusion. The intervention seems to have improved the patients' risk perception, anxiety and satisfaction with the communication, which are important conditions for shared decision making. However, we found no additional effect of the intervention on lifestyle.
AB - Objective. To determine if lifestyle improved at a short term through an intervention to involve patients in cardiovascular risk management by the practice nurse. Methods. The IMPALA study (2006, the Netherlands) was a cluster-randomised controlled trial involving 25 general practices and 615 patients who were eligible for cardiovascular risk management. The intervention consisted of (1) individual 10-year cardiovascular risk assessment, (2) risk communication, (3) use of a decision aid and (4) adapted motivational interviewing, applied by practice nurses in two consultations. Outcomes were smoking, alcohol, diet, physical activity and the secondary outcomes risk perception, anxiety, confidence about the decision and satisfaction with the communication, measured at baseline and after 12 weeks. Results. Patients of both groups improved their lifestyle, but no relevant significant differences between the groups were found. Intervention group patients improved in terms of the appropriateness of risk perception, although not significantly. Intervention group patients improved significantly in terms of appropriateness of anxiety and were more satisfied with the communication compared to control group patients. Conclusion. The intervention seems to have improved the patients' risk perception, anxiety and satisfaction with the communication, which are important conditions for shared decision making. However, we found no additional effect of the intervention on lifestyle.
KW - Multiple behaviour change
KW - Primary prevention
KW - Cardiovascular diseases
KW - Primary care
KW - Practice nurses
KW - Shared decision making
KW - Risk communication
KW - Motivational interviewing
KW - Randomized controlled trial
U2 - 10.1016/j.ypmed.2009.11.007
DO - 10.1016/j.ypmed.2009.11.007
M3 - Article
C2 - 19944713
SN - 0091-7435
VL - 50
SP - 35
EP - 44
JO - Preventive Medicine
JF - Preventive Medicine
IS - 1-2
ER -