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Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk: A randomized controlled trial

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Abstract

Background: We implemented a comprehensive intervention program targeting general practice staff, that proved successful in optimizing practice organization and clinical decision-making. In this paper, health-related quality of life (HRQL) is investigated as a clinical outcome. Objective: To evaluate the effect of the implementation of an intervention program on the HRQL in patients at high cardiovascular risk. Research design: Randomized controlled trial. Intervention practices (n = 62) received a comprehensive intervention program (by means of outreach visitors) lasting 21 months. HRQL of patients at high cardiovascular risk was assessed by the MOS 36-Item Short-Form Health Survey (SF-36), at baseline and after intervention. Three patient categories were distinguished: diabetes mellitus, cardiovascular disease and hypertension. Results: HRQL deteriorated in all respondents, but more pronounced in the control group. In diabetes patients the differences between intervention and control group were significant for the Vitality and Mental Health scales, with mean difference in change of 3.93 (95% CI: 1.08–6.78) and 3.71 (95% CI: 0.73–6.68), respectively. Patients with cardiovascular disease had significantly different changes on three scales: physical functioning (3.57, 95% CI: 0.71–6.43), vitality (3.01, 95% CI: 0.72–5.30) and social functioning (3.96, 95% CI: 0.50–7.42). In patients with hypertension, there were no differences between the intervention and control group. Conclusion: Our comprehensive intervention program resulted in changes in HRQL on several domains, particularly in patients with diabetes and cardiovascular disease.

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References

  1. Metsemakers JF, Hoppener P, Knottnerus JA, et al. Computerized health information in The Netherlands: A registration network of family practices. Br J Gen Pract 1992; 42: 102-106.

    Google Scholar 

  2. Campbell NC, Thain J, Deans HG, et al. Secondary prevention clinics for coronary heart disease: Randomised trial of effect on health. Br Med J 1998; 316: 1434-1437.

    Google Scholar 

  3. van Drenth B, Hulscher M, Mokkink H, et al. Health perception of patients after cardiovascular risk detection and after intervention in general practice. Prev Cardiol 2001; 4: 23-27.

    Google Scholar 

  4. Jolly K, Bradley F, Sharp S, et al. Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: Final results of the Southampton heart integrated care project (SHIP). The SHIP Collaborative Group. Br Med J 1999; 318: 706-711.

    Google Scholar 

  5. Hellenius ML, Dahlof C, Aberg H, et al. Quality of life is not negatively affected by diet and exercise intervention in healthy men with cardiovascular risk factors. Qual Life Res 1995; 4: 13-20.

    Google Scholar 

  6. Hulscher MEJL, Wensing M, van der Weijden T, Grol R. Interventions to implement prevention in primary care (Cochrane Review). In: The Cochrane Library, Issue 2, Oxford: Update Software, 2002.

    Google Scholar 

  7. Lobo CM, Frijling BD, Hulscher MEJL, et al. Improving quality of organizing cardiovascular preventive care in general practice by outreach visitors: A randomized controlled trial. Prev Med 2002; 35: 422-429.

    Google Scholar 

  8. Wood D, De Backer G, Faergeman O, et al. Prevention of coronary heart disease in clinical practice. Blood Press 1998; 7: 262-269.

    Google Scholar 

  9. Marteau TM. Screening in practice: Reducing the psychological costs. Br Med J 1990; 301: 26-28.

    Google Scholar 

  10. Moher M, Schofield T, Weston S, Fullard E. Managing established coronary heart disease. Br Med J 1997; 315: 69-70.

    Google Scholar 

  11. Frijling BF. Management of patients at high cardiovascular risk. Thesis. Nijmegen, 2002.

  12. Pearlman RA, Uhlmann RF. Quality of life in chronic diseases: Perceptions of elderly patients. J Gerontol 1988; 43: 25-30.

    Google Scholar 

  13. Bardage C, Isacson DG. Hypertension and health-related quality of life: An epidemiological study in Sweden. J Clin Epidemiol 2001; 54: 172-181.

    Google Scholar 

  14. van de Lisdonk EH, van de Bosch WJHM, Huygen FJA, Lagro-Jansen ALM. Ziekten in de huisartspraktijk. Utrecht: Wetenschappelijke uitgeverij Bunge, 1990.

    Google Scholar 

  15. Hulscher ME, van Drenth BB, van der Wouden JC, et al. Changing preventive practice: A controlled trial on the effects of outreach visits to organise prevention of cardiovascular disease. Qual Health Care 1997; 6: 19-24.

    Google Scholar 

  16. Bouchet C, Guillemin F, Paul-Dauphin A, et al. Selection of quality-of-life measures for a prevention trial: A psychometric analysis. Control Clin Trials 2000; 21: 30-43.

    Google Scholar 

  17. Aaronson NK, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, et al. International Quality of Life Assessment (IQOLA) Project. Qual Life Res 1992; 1: 349-351.

    Google Scholar 

  18. McHorney CA, Ware JE, Raczek AE. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247-263.

    Google Scholar 

  19. McHorney CA, Ware JE, Lu JF, et al. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40-66.

    Google Scholar 

  20. Aarsonson NK, Muller M, Cohen PDA, et al. Translation, validation and norming of the Dutch language version if the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol 1998; 51: 1055-1068.

    Google Scholar 

  21. Halbert JA, Silagy CA, Finucane PM, et al. Physical activity and cardiovascular risk factors: Effect of advice from an exercise specialist in Australian general practice. Med J Aust 2000; 173: 84-87.

    Google Scholar 

  22. Ware JE Jr. SF-36 health survey update. Spine 2000; 25: 3130-3139.

    Google Scholar 

  23. Cupples ME, McKnight A. Five year follow up of patients at high cardiovascular risk who took part in randomised controlled trial of health promotion. Br Med J 1999; 319: 687-688.

    Google Scholar 

  24. Wagner EH, Grothaus LC, Sandhu N, et al. Chronic care clinics for diabetes in primary care. Diabet Care 2001; 25: 695-700.

    Google Scholar 

  25. Zyczynski TM, Leiy NK, Kong BW, et al. Effects of candesartan cilexetil on health-related quality of life in black patients with systemic hypertension in the ABC Trial. Heart Dis 2000; 2: 389-391.

    Google Scholar 

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Authors and Affiliations

  1. Department of General Practice, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands

    C.M. Lobo, R.M.D. Bernsen, A. Prins & J.C. van der Wouden

  2. Centre for Quality of Care Research, University of Nijmegen and Maastricht, Nijmegen, The Netherlands

    B.D. Frijling, M.E.J.L. Hulscher & R.P.T.M. Grol

Authors
  1. C.M. Lobo
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  2. B.D. Frijling
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  3. M.E.J.L. Hulscher
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  4. R.M.D. Bernsen
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  5. R.P.T.M. Grol
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  6. A. Prins
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  7. J.C. van der Wouden
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Lobo, C., Frijling, B., Hulscher, M. et al. Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk: A randomized controlled trial. Qual Life Res 13, 73–80 (2004). https://doi.org/10.1023/B:QURE.0000015285.08673.42

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  • DOI: https://doi.org/10.1023/B:QURE.0000015285.08673.42

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