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

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

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 journal › Article › Academic › peer-review

19 Citations (Scopus)

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 language	English
Pages (from-to)	73-80
Number of pages	8
Journal	Quality of life research
Volume	13
Issue number	1
DOIs	https://doi.org/10.1023/B:QURE.0000015285.08673.42
Publication status	Published - Feb 2004
Externally published	Yes

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

Access to Document

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

Cite this

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. (2004). Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk: a randomized controlled trial. Quality of life research, 13(1), 73-80. https://doi.org/10.1023/B:QURE.0000015285.08673.42

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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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Lobo, CM, Frijling, BD, Hulscher, MEJL, Bernsen, RMD, Grol, RPTM, Prins, A & van der Wouden, JC 2004, 'Effect of a comprehensive intervention program targeting general practice staff on quality of life in patients at high cardiovascular risk: a randomized controlled trial', Quality of life research, vol. 13, no. 1, pp. 73-80. https://doi.org/10.1023/B:QURE.0000015285.08673.42

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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

AU - Grol, R P T M

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 - Family Practice/education

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KW - Hypertension/prevention & control

KW - Male

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 - https://doi.org/10.1023/B:QURE.0000015285.08673.42

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