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EnglishBackground and aim: This cluster randomized trial evaluated the efficacy of a disease and care management (D&CM) model in cardiovascular (CVD) prevention in primary care. Methods and results: Eligible subjects had ≥1 among: blood pressure≥140/90mmHg; glycated hemoglobin≥7%; LDL-cholesterol≥160 or ≥100mg/dL (primary or secondary prevention, respectively); BMI≥30; current smoking. The D&CM intervention included a teamwork including nurses as care managers for the implementation of tailored care plans. Control group was allocated to usual-care. The main outcome was the proportion of subjects achieving recommended clinical targets for ≥1 of uncontrolled CVD risk factors at 12-month. During 2008-2009 we enrolled 920 subjects in the Abruzzo/Marche regions, Italy. Following the exclusion of L'Aquila due to 2009 earthquake, final analyses included 762 subjects. The primary outcome was achieved by 39.1% (95%CI: 34.2-44.2) and 25.2% (95%CI: 20.9-29.9) of subjects in the intervention and usual-care group, respectively (p<0.001). The D&CM intervention significantly increased the proportion of subjects who achieved clinical targets for both diabetes and hypertension, with no differences in hypercholesterolemia, smoking status and obesity. Conclusions: The D&CM intervention was effective in controlling cardiovascular risk factors, in particular hypertension and diabetes. Numbers needed to treat were small. Such intervention may deserve further consideration in clinical practice. Registration number: ACTRN12611000813987. © 2013 Elsevier B.V.
| Titolo: | Care manager to control cardiovascular risk factors in primary care: The Raffaello cluster randomized trial | |
| Autore/i: | Deales, A.; Fratini, M.; Romano, S.; Rappelli, A.; Penco, M.; Perna, G. Piero; Beccaceci, G.; Borgia, R.; Palumbo, W.; Magi, M.; Vespasiani, G.; Bronzini, M.; Musilli, A.; Nocciolini, M.; Mezzetti, A.; MANZOLI, Lamberto | |
| Autore/i Unibo: | ||
| Anno: | 2014 | |
| Rivista: | ||
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.numecd.2013.11.008 | |
| Abstract: | Background and aim: This cluster randomized trial evaluated the efficacy of a disease and care management (D&CM) model in cardiovascular (CVD) prevention in primary care. Methods and results: Eligible subjects had ≥1 among: blood pressure≥140/90mmHg; glycated hemoglobin≥7%; LDL-cholesterol≥160 or ≥100mg/dL (primary or secondary prevention, respectively); BMI≥30; current smoking. The D&CM intervention included a teamwork including nurses as care managers for the implementation of tailored care plans. Control group was allocated to usual-care. The main outcome was the proportion of subjects achieving recommended clinical targets for ≥1 of uncontrolled CVD risk factors at 12-month. During 2008-2009 we enrolled 920 subjects in the Abruzzo/Marche regions, Italy. Following the exclusion of L'Aquila due to 2009 earthquake, final analyses included 762 subjects. The primary outcome was achieved by 39.1% (95%CI: 34.2-44.2) and 25.2% (95%CI: 20.9-29.9) of subjects in the intervention and usual-care group, respectively (p<0.001). The D&CM intervention significantly increased the proportion of subjects who achieved clinical targets for both diabetes and hypertension, with no differences in hypercholesterolemia, smoking status and obesity. Conclusions: The D&CM intervention was effective in controlling cardiovascular risk factors, in particular hypertension and diabetes. Numbers needed to treat were small. Such intervention may deserve further consideration in clinical practice. Registration number: ACTRN12611000813987. © 2013 Elsevier B.V. | |
| Data stato definitivo: | 2022-02-21T16:41:08Z | |
| Appare nelle tipologie: | 1.01 Articolo in rivista |
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