Improving cardiovascular risk management: a randomized, controlled trial on the effect of a decision support tool for patients and physicians

Background There is nonoptimal adherence of general practitioners (GPs) and patients to cardiovascular risk reducing interventions. GPs find it difficult to assimilate multiple risk factors into an accurate assessment of cardiovascular risk. In addition, communicating cardiovascular risk to patients...

Full description

Saved in:
Bibliographic Details
Published in:European journal of cardiovascular prevention and rehabilitation 2007-02, Vol.14 (1), p.44-50
Main Authors: Steenkiste, Ben van, Weijden, Trudy van der, Stoffers, Henri E.J.H., Kester, Arnold D.M., Timmermans, Danielle R.M., Grol, Richard
Format: Article
Language:English
Subjects:
Adult
Aged
Anxiety - epidemiology
Attitude to Health
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Decision Support Techniques
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Education as Topic
Patient Participation
Physicians, Family - standards
Professional Practice - standards
Risk Assessment - methods
Risk Reduction Behavior
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background There is nonoptimal adherence of general practitioners (GPs) and patients to cardiovascular risk reducing interventions. GPs find it difficult to assimilate multiple risk factors into an accurate assessment of cardiovascular risk. In addition, communicating cardiovascular risk to patients has proved to be difficult. Aims Improving primary prevention of cardiovascular disease (CVD) in primary care by enhancing patient involvement in the use of a decision support tool. Design Cluster randomized trial. Methods Thirty-four GPs included patients (40-75 years old) without CVD. In an interactive, small group training session lasting 4h, the GPs in the intervention group were trained to use the guidelines on cardiovascular risk and a decision support tool. The control group received educational materials about the guidelines on paper. GPs’ clinical performance and patients’ risk perception and self-reported lifestyles were measured at baseline and after 6 months. Results Thirty-four GPs recorded 490 consultations, 276 in the intervention and 214 in the control group. After 6 months, no significant effect of the intervention on the GPs’ performance or the patients’ risk perception was found. There was only an effect on self-reported lifestyle, in that more men in the intervention group than in the control group increased their physical activity (odds ratio 3.8, 95% confidence interval 1.7–8.7). Conclusion The 4-h interactive, small group training did not guarantee correct application of the decision support tool and as such failed to improve GPs’ performance or correct patients’ risk perception. The positive effect on physical activity justifies further research on patient involvement. Eur J Cardiovasc Prev Rehabil 14: 44-50 © 2007 The European Society of Cardiology
ISSN:2047-4873
1741-8267
2047-4881
DOI:10.1097/01.hjr.0000239475.71805.1e