Hypertension Clinical Trial
Official title:
A Randomized Controlled Trial of the Effects and Expense of a Primary and Secondary Cardiovascular Risk Reduction Clinic in Primary Care
The purpose of this trial is to study the effects on risk reduction and expense of 3 approaches to the care of people with cardiovascular risk factors in a naturalistic primary care environment.
Background: Uncontrolled hypertension, hyperlipidemia, hyperglycemia, smoking and other
cardiovascular risks remain at epidemic proportions despite known efficacious treatments.
Issues of both provider and patient behavioral non-adherence to guidelines and therapeutic
regimes, respectively, are key factors in non-control. Few interventions aimed at reducing
cardiovascular risk factors are based on sound theories of behavior change.
Objective: To assess the effectiveness and expense of three approaches to the care of
persons with known risks for cardiovascular disease. The three treatment approaches are
usual care, usual care plus nurse telephone calls, and usual care plus clinic visits to a
nurse and/or physician.
Design: Patients will be randomized to a 1) specialized proactive, and holistic
cardiovascular risk management clinic using principles of behavior change; 2) nurse
telephone calls as an attention placebo, yet a low dose, health promotion intervention; and
3) usual primary care. A random sample of 670 patients with cardiovascular risks identified
in the past five years will be selected. Patients will be excluded if they do not speak
English, are cognitively impaired or live in a nursing home. Interview questionnaires will
measure cardiovascular risk, intention to change, social support, depression, coping and
health services use. In addition, patients will be required to give a blood sample to
measure cholesterol and glucose levels. Patients will then be randomized to one of three
treatment groups.
Significance: The expected findings of this study is that the cardiovascular clinic, with
nurse and physician, will be most effective at reducing cardiovascular risk and will pay for
itself by averting hospital and emergency use for cardiovascular events.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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