Background: We examined the effectiveness of a structured collaboration in general practice between a practice nurse, a peer health educator, the general practitioner (GP) and a GP assistant in providing intensified preventive care for patients at high risk of developing cardiovascular diseases. DESIGN: A randomized controlled trial in three healthcare centres (18 GPs) in deprived neighbourhoods of two major Dutch cities. Methods: Two hundred seventy-five high-risk patients (30-70 years) from various ethnic groups were randomized to intervention (n=137) or usual care group (n=138). We determined group differences in outcomes [10-year absolute risk (Framingham risk equation), blood pressure, lipids and body mass index] at 12-month follow-up. Results: The 10-year absolute risk was reduced by 1.76% (standard error: 0.81) in intervention and by 2.27% (standard error: 0.69) in usual care group; the difference in mean change was 0.88% [95% confidence interval: -1.16 to 2.93]. In both groups significant reductions were observed in the following individual risk factors: total cholesterol, total cholesterol/high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, with no relevance between group differences. Conclusion: The cardiovascular risk profile of intervention and control patients improved after 1-year follow-up. However, no extra effect of the structured preventive care on the risk for cardiovascular diseases was achieved.

Additional Metadata
Keywords Cardiovascular risk, Deprived neighbourhoods, General practice, Practice nurse, Secondary prevention
Persistent URL dx.doi.org/10.1097/HJR.0b013e3282fceac2, hdl.handle.net/1765/32379
Citation
El Fakiri, F, Bruijnzeels, M.A, Uitewaal, P.J.M, Frenken, R.A.A, Berg, M, & Hoes, A.W. (2008). Intensified preventive care to reduce cardiovascular risk in healthcare centres located in deprived neighbourhoods: A randomized controlled trial. European Journal of Cardiovascular Prevention & Rehabilitation, 15(4), 488–493. doi:10.1097/HJR.0b013e3282fceac2