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

C M Lobo, B D Frijling, M E J L Hulscher, R M D Bernsen, R P T M Grol, A Prins, J C van der Wouden

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalQuality of Life Research
Volume13
Issue number1
DOIs
Publication statusPublished - Feb 2004

Cite this

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title = "Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk: a randomized controlled trial",
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.",
keywords = "Aged, Cardiovascular Diseases/prevention & control, Community-Institutional Relations, Comprehensive Health Care/standards, Diabetes Mellitus/prevention & control, Family Practice/education, Female, Humans, Hypertension/prevention & control, Male, Middle Aged, Netherlands, Program Evaluation, Quality of Life, Risk Assessment, Self-Assessment, Sickness Impact Profile, Surveys and Questionnaires",
author = "Lobo, {C M} and Frijling, {B D} and Hulscher, {M E J L} and Bernsen, {R M D} and Grol, {R P T M} and A Prins and {van der Wouden}, {J C}",
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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. / Lobo, C M; Frijling, B D; Hulscher, M E J L; Bernsen, R M D; Grol, R P T M; Prins, A; van der Wouden, J C.

In: Quality of Life Research, Vol. 13, No. 1, 02.2004, p. 73-80.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk

T2 - a randomized controlled trial

AU - Lobo, C M

AU - Frijling, B D

AU - Hulscher, M E J L

AU - Bernsen, R M D

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AU - Prins, A

AU - van der Wouden, J C

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N2 - 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.

AB - 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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KW - Comprehensive Health Care/standards

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KW - Humans

KW - Hypertension/prevention & control

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KW - Middle Aged

KW - Netherlands

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KW - Quality of Life

KW - Risk Assessment

KW - Self-Assessment

KW - Sickness Impact Profile

KW - Surveys and Questionnaires

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DO - 10.1023/B:QURE.0000015285.08673.42

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JO - Quality of Life Research

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SN - 0962-9343

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