A randomized, controlled trial for risk factor reduction in patients with symptomatic vascular disease: the multidisciplinary Vascular Prevention by Nurses Study (VENUS)

Goessens, Bertine M.B.; Visseren, Frank L.J.; Sol, Berna G.M.; Ginkel, Janneke M. de Man‐van; Graaf, Yolanda van der

doi:10.1097/01.hjr.0000216549.92184.40

Cited by 30 publications

(26 citation statements)

References 42 publications

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“…They logged in a median of 56 (interquartile range 35-83) times during the year (supplementary tableB). Patients (n=134) sent a median 14(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) messages, and 131 patients entered a median 7(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) measurements during the year. Measurements most often entered related to blood pressure (111 patients, median 2 (2-6)) and weight (114 patients, median 3(1-6)).…”

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confidence: 99%

Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial

Vernooij

Kaasjager²,

Graaf³

et al. 2012

BMJ

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Objective To investigate whether an internet based, nurse led vascular risk factor management programme promoting self management on top of usual care is more effective than usual care alone in reducing vascular risk factors in patients with clinically manifest vascular disease. Design Prospective randomised controlled trial.Setting Multicentre trial in secondary and tertiary healthcare setting.Participants 330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with at least two treatable risk factors not at goal.Intervention Personalised website with an overview and actual status of patients' risk factors and mail communication via the website with a nurse practitioner for 12 months; the intervention combined self management support, monitoring of disease control, and drug treatment. Main outcome measuresThe primary endpoint was the relative change in Framingham heart risk score after 1 year. Secondary endpoints were absolute changes in the levels of risk factors and the differences between groups in the change in proportion of patients reaching treatment goals for each risk factor.Results Participants' mean age was 59.9 (SD 8.4) years, and most patients (n=246; 75%) were male. After 1 year, the relative change in Framingham heart risk score of the intervention group compared with the usual care group was −14% (95% confidence interval −25% to −2%). At baseline, the Framingham heart risk score was higher in the intervention group than in the usual care group (16.1 (SD 10.6) v 14.0 (10.5)), so the outcome was adjusted for the separate variables of the Framingham heart risk score and for the baseline Framingham heart risk score. This produced a relative change of −12% (−22% to −3%) in Framingham heart risk score for the intervention group compared with the usual care group adjusted for the separate variables of the score and −8% (−18% to 2%) adjusted for the baseline score. Of the individual risk factors, a difference between groups was observed in low density lipoprotein cholesterol (−0.3, −0.5 to −0.1, mmol/L) and smoking (−7.7%, −14.9% to −0.4%). Some other risk factors tended to improve (body mass index, triglycerides, systolic blood pressure, renal function) or tended to worsen (glucose concentration, albuminuria). ConclusionAn internet based, nurse led treatment programme on top of usual care for vascular risk factors had a small effect on lowering vascular risk and on lowering of some vascular risk factors in patients with vascular disease. Trial registration Clinical trials NCT00785031. IntroductionPatients with a recent clinical manifestation of a vascular disease (such as myocardial infarction, stroke, or peripheral arterial disease) are at increased risk for developing a new vascular event or death.1 More patients survive an acute vascular event nowadays, and as a consequence the total number of patients in the chronic phase of vascular disease is increasing. Established strategies to reduce vascular risk are treating hypertensi...

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confidence: 99%

Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial

Vernooij

Kaasjager²,

Graaf³

et al. 2012

BMJ

View full text Add to dashboard Cite

show abstract

“…None of the studies evaluated the professionals, nor their mutual interactions, and consequently left out issues concerned with the way social influences might have impact on the intervention (Table 1). Nor the place of intervention is pointed out as significant for or as an evaluation parameter for the outcome of the intervention in the study of Goessens et al's (2006). It became clear that none of the studies in this literature review evaluate the social contexts' influence and impact on the intervention (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The concept of the control arms was described in 38 studies, but unspecified and only stated as "usual practice/usual care" in 17 studies (Table 1). This could be illustrated by the study of Goessens et al (2006):…”

Section: Resultsmentioning

confidence: 99%

“…Taking all into consideration, none of the studies included, incorporated or reflected on the meaning and importance of contextual aspects in the study design or consequently in the evaluation of the studies. (Goessens et al 2006.…”

Section: Resultsmentioning

confidence: 99%

“…Further, all intervention in the studies were evaluated by quantitative measurement taking into account the patient as a sole actor and nine of these studies also measured on cost-benefit of the intervention. Again the study of Goessens et al (2006) Thus the nurse is an active part in above mentioned intervention in the study of Goessens et al's (2006) and interacts with the patient (s)he is not regarded as a part or a component of the evaluation concept of the intervention. None of the studies evaluated the professionals, nor their mutual interactions, and consequently left out issues concerned with the way social influences might have impact on the intervention (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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A randomized, controlled trial for risk factor reduction in patients with symptomatic vascular disease: the multidisciplinary Vascular Prevention by Nurses Study (VENUS)

Abstract: Treatment delivered by nurse practitioners, in addition to a vascular risk factor screening and prevention program, resulted in a better management of vascular risk factors than usual care alone in vascular patients after 1-year follow-up.

Cited by 30 publications

References 42 publications

Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial

Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial

Nurse-led interventions in the concept of randomized controlled trials – critical perspectives on how to handle social contexts

Interventions for improving modifiable risk factor control in the secondary prevention of stroke

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