The effects of patient characteristics and beliefs on responses to behavioral interventions for control of chronic diseases

Given, Charles W.; Given, Barbara; Coyle, Bryan W.

doi:10.1016/0738-3991(84)90070-3

Cited by 13 publications

(2 citation statements)

References 12 publications

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“…One trial was excluded after consultation with clinical experts as it was a trial of primary prevention in which participants had a mean baseline blood pressure of 127/85 mmHg [154]. Eight trials of unusual interventions: paranormal healing [146], diverse manipulations of intake of electrolytes [147][148][149], health beliefs [150], chiropractice [151], guava [152,153], were excluded from meta-analyses as they could not reasonably be combined with other trials. A further 21 trials were excluded because of missing data (standard deviations or numbers of participants randomized).…”

Section: Trial Flowmentioning

confidence: 99%

Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Dickinson

Mason²,

Nicolson³

et al. 2006

Journal of Hypertension

657

391

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Section: Trial Flowmentioning

confidence: 99%

Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Dickinson

Mason²,

Nicolson³

et al. 2006

Journal of Hypertension

657

391

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“…CHD event rates higher in intervention group but stroke rates significantly lower. Concluded that adverse effects of drug treatment may explain lack of benefit Given 1984…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Multiple risk factor interventions for primary prevention of coronary heart disease

Ebrahim

Beswick

Burke

et al. 2006

Cochrane Database of Systematic Reviews

171

174

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Background Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease. Search strategy MEDLINE was searched for the original review to 1995. This was updated by searching the Cochrane Central Register of Controlled Trials on The Cochrane Library Issue 3 2001, MEDLINE(2000 to September 2001) and EMBASE (1998 to September 2001). Selection criteria Intervention studies using counselling or education to modify more than one cardiovascular risk factor in adults from general populations, occupational groups, or high risk groups. Trials of less than 6 months duration were excluded. Data collection and analysis Data were extracted by two reviewers independently. Investigators were contacted to obtain missing information. Main results A total of 39 trials were found of which ten reported clinical event data. In the ten trials with clinical event end-points, the pooled odds ratios for total and CHD mortality were 0.96 (95% confidence intervals (CI) 0.92 to 1.01) and 0.96 (95% CI 0.89 to 1.04) respectively. Net changes in systolic and diastolic blood pressure, and blood cholesterol were (weighted mean differences) −3.6 mmHg (95% CI −3.9 to −3.3 mmHg), −2.8 mmHg (95% CI −2.9 to −2.6 mmHg) and −0.07 mMol/l (95% CI −0.8 to −0.06 mMol/l) respectively. Odds of reduction in smoking prevalence was 20% (95% CI 8% to 31%). Statistical heterogeneity between the studies with respect to mortality and risk factor changes was due to trials focusing on hypertensive participants and those using considerable amounts of drug treatment. Authors’ conclusions The pooled effects suggest multiple risk factor intervention has no effect on mortality. However, a small, but potentially important, benefit of treatment (about a 10% reduction in CHD mortality) may have been missed. Risk factor changes were relatively modest, were related to the amount of pharmacological treatment used, and in some cases may have been over-estimated because of regression to the mean effects, lack of intention to treat analyses, habituation to blood pressure measurement, and use of self-reports of smoking. Interventions using personal or family counselling and education with or without pharmacological treatments appear to be more effective at achieving risk factor reduction and consequent reductions in mortality in high risk hypertensive populations. The evidence suggests that such interventions have limited utility in the general population.

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Multiple risk factor interventions for primary prevention of coronary heart disease

Ebrahim

Taylor

Ward

et al. 2011

Cochrane Database of Systematic Reviews

273

113

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Background-Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives-To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease.

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The effects of patient characteristics and beliefs on responses to behavioral interventions for control of chronic diseases

Cited by 13 publications

References 12 publications

Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Multiple risk factor interventions for primary prevention of coronary heart disease

Multiple risk factor interventions for primary prevention of coronary heart disease

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