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Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: A cluster-randomized controlled trial in primary care

Koelewijn-van Loon, Marije S., van der Weijden, Trudy, Ronda, Gaby, van Steenkiste, Ben, Winkens, Bjorn, Elwyn, Glyn and Grol, Richard 2010. Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: A cluster-randomized controlled trial in primary care. Preventive Medicine 50 (1-2) , pp. 35-44. 10.1016/j.ypmed.2009.11.007

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Abstract

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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Uncontrolled Keywords: Multiple behaviour change; Primary prevention; Cardiovascular diseases; Primary care; Practice nurses; Shared decision making; Risk communication; Motivational interviewing; Randomized controlled trial
Publisher: Elsevier
ISSN: 0091-7435
Last Modified: 19 Mar 2016 22:44
URI: http://orca-mwe.cf.ac.uk/id/eprint/25706

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