PT  - JOURNAL ARTICLE
AU  - Koelewijn-van Loon, Marije S.
AU  - van der Weijden, Trudy
AU  - van Steenkiste, Ben
AU  - Ronda, Gaby
AU  - Winkens, Bjorn
AU  - Severens, Johan L.
AU  - Wensing, Michel
AU  - Elwyn, Glyn
AU  - Grol, Richard
TI  - Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial
AID  - 10.1503/cmaj.081591
DP  - 2009 Dec 08
TA  - Canadian Medical Association Journal
PG  - E267--E274
VI  - 181
IP  - 12
4099  - http://www.cmaj.ca/content/181/12/E267.short
4100  - http://www.cmaj.ca/content/181/12/E267.full
SO  - CMAJ2009 Dec 08; 181
AB  - Background: Preventive guidelines on cardiovascular risk management recommend lifestyle changes. Support for lifestyle changes may be a useful task for practice nurses, but the effect of such interventions in primary prevention is not clear. We examined the effect of involving patients in nurse-led cardiovascular risk management on lifestyle adherence and cardiovascular risk. Methods: We performed a cluster randomized controlled trial in 25 practices that included 615 patients. The intervention consisted of nurse-led cardiovascular risk management, including risk assessment, risk communication, a decision aid and adapted motivational interviewing. The control group received a minimal nurse-led intervention. The self-reported outcome measures at one year were smoking, alcohol use, diet and physical activity. Nurses assessed 10-year cardiovascular mortality risk after one year. Results: There were no significant differences between the intervention groups. The effect of the intervention on the consumption of vegetables and physical activity was small, and some differences were only significant for subgroups. The effects of the intervention on the intake of fat, fruit and alcohol and smoking were not significant. We found no effect between the groups for cardiovascular 10-year risk. Interpretation: Nurse-led risk communication, use of a decision aid and adapted motivational interviewing did not lead to relevant differences between the groups in terms of lifestyle changes or cardiovascular risk, despite significant within-group differences.