Cargando…
Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial
BACKGROUND: To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817988/ https://www.ncbi.nlm.nih.gov/pubmed/32375491 http://dx.doi.org/10.1177/1474515120919547 |
_version_ | 1783638747329331200 |
---|---|
author | Westland, Heleen Schuurmans, Marieke J Bos-Touwen, Irene D de Bruin-van Leersum, Marjolein A Monninkhof, Evelyn M Schröder, Carin D de Vette, Daphne A Trappenburg, Jaap CA |
author_facet | Westland, Heleen Schuurmans, Marieke J Bos-Touwen, Irene D de Bruin-van Leersum, Marjolein A Monninkhof, Evelyn M Schröder, Carin D de Vette, Daphne A Trappenburg, Jaap CA |
author_sort | Westland, Heleen |
collection | PubMed |
description | BACKGROUND: To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutch primary care. AIM: The aim of this study was to evaluate the effectiveness of the Activate intervention and identifying which patient-related characteristics modify the effect. METHODS: A two-armed cluster-randomised controlled trial was conducted comparing the intervention with care as usual. The intervention consisted of four nurse-led behaviour change consultations within a 3-month period. Data were collected at baseline, 3 months and 6 months. Primary outcome was the daily amount of moderate to vigorous physical activity at 6 months. Secondary outcomes included sedentary behaviour, self-efficacy for physical activity, patient activation for self-management and health status. Prespecified effect modifiers were age, body mass index, level of education, social support, depression, patient provider relationship and baseline physical activity. RESULTS: Thirty-one general practices (n = 195 patients) were included (intervention group n = 93; control group n = 102). No significant between-group difference was found for physical activity (mean difference 2.49 minutes; 95% confidence interval -2.1; 7.1; P = 0.28) and secondary outcomes. Patients with low perceived social support (P = 0.01) and patients with a low baseline activity level (P = 0.02) benefitted more from the intervention. CONCLUSION: The Activate intervention did not improve patients’ physical activity and secondary outcomes in primary care patients at risk of cardiovascular disease. To understand the results, the intervention fidelity and active components for effective self-management require further investigation. Trial registration: ClinicalTrials.gov NCT02725203. |
format | Online Article Text |
id | pubmed-7817988 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-78179882021-02-03 Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial Westland, Heleen Schuurmans, Marieke J Bos-Touwen, Irene D de Bruin-van Leersum, Marjolein A Monninkhof, Evelyn M Schröder, Carin D de Vette, Daphne A Trappenburg, Jaap CA Eur J Cardiovasc Nurs Original Articles BACKGROUND: To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutch primary care. AIM: The aim of this study was to evaluate the effectiveness of the Activate intervention and identifying which patient-related characteristics modify the effect. METHODS: A two-armed cluster-randomised controlled trial was conducted comparing the intervention with care as usual. The intervention consisted of four nurse-led behaviour change consultations within a 3-month period. Data were collected at baseline, 3 months and 6 months. Primary outcome was the daily amount of moderate to vigorous physical activity at 6 months. Secondary outcomes included sedentary behaviour, self-efficacy for physical activity, patient activation for self-management and health status. Prespecified effect modifiers were age, body mass index, level of education, social support, depression, patient provider relationship and baseline physical activity. RESULTS: Thirty-one general practices (n = 195 patients) were included (intervention group n = 93; control group n = 102). No significant between-group difference was found for physical activity (mean difference 2.49 minutes; 95% confidence interval -2.1; 7.1; P = 0.28) and secondary outcomes. Patients with low perceived social support (P = 0.01) and patients with a low baseline activity level (P = 0.02) benefitted more from the intervention. CONCLUSION: The Activate intervention did not improve patients’ physical activity and secondary outcomes in primary care patients at risk of cardiovascular disease. To understand the results, the intervention fidelity and active components for effective self-management require further investigation. Trial registration: ClinicalTrials.gov NCT02725203. SAGE Publications 2020-05-06 2020-12 /pmc/articles/PMC7817988/ /pubmed/32375491 http://dx.doi.org/10.1177/1474515120919547 Text en © The European Society of Cardiology 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Westland, Heleen Schuurmans, Marieke J Bos-Touwen, Irene D de Bruin-van Leersum, Marjolein A Monninkhof, Evelyn M Schröder, Carin D de Vette, Daphne A Trappenburg, Jaap CA Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial |
title | Effectiveness of the nurse-led Activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
title_full | Effectiveness of the nurse-led Activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
title_fullStr | Effectiveness of the nurse-led Activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
title_full_unstemmed | Effectiveness of the nurse-led Activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
title_short | Effectiveness of the nurse-led Activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
title_sort | effectiveness of the nurse-led activate intervention in patients at
risk of cardiovascular disease in primary care: a cluster-randomised controlled
trial |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817988/ https://www.ncbi.nlm.nih.gov/pubmed/32375491 http://dx.doi.org/10.1177/1474515120919547 |
work_keys_str_mv | AT westlandheleen effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT schuurmansmariekej effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT bostouwenirened effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT debruinvanleersummarjoleina effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT monninkhofevelynm effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT schrodercarind effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT devettedaphnea effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial AT trappenburgjaapca effectivenessofthenurseledactivateinterventioninpatientsatriskofcardiovasculardiseaseinprimarycareaclusterrandomisedcontrolledtrial |