title: Effects of a brief cardiovascular prevention program by a health advisor in primary care; the 'Hartslag Limburg' project, a cluster randomized trial.
abstract: OBJECTIVE
  To determine in primary care patients at high risk for a cardiovascular event, the effects on biomedical risk factors for and incidence of cardiovascular events, of a brief cardiovascular prevention program executed by a health advisor.
  
  
  METHODS
  
  
  
  METHODS
  cluster randomized controlled trial with 1275 patients (24 general practices) in and around Maastricht, the Netherlands (1999-2004).
  
  
  METHODS
  health advisors were to complete computerized cardiovascular risk profiles, provide multi-factorial tailored health education and advice, and communicate with GP's to optimize treatment.
  
  
  RESULTS
  differences in changes in risk factors between baseline and follow up at 6, 18, and 36 months and incidence of cardiovascular events at 36 months.
  
  
  RESULTS
  
  
  
  METHODS
  Because of logistic reasons risk profiles were put on paper instead of in the computerized patient files. On average patients attended 2.3 counseling sessions. Interaction with GPs was less productive than expected.
  
  
  RESULTS
  Effect after six months on BMI (-0.20 kg/m(2) (95% CI -0.38 to -0.01, p=0.039), Cohen's d: -0.18), and after 18 months on HDL-cholesterol (+0.05 mmol/l (95% CI +0.01 to +0.09, p=0.014), Cohen's d: 0.14). No other (subgroup) effects were found.
  
  
  CONCLUSIONS
  Given the lack of clinically meaningful effects, implementation of this intervention in its present form is not justified.
authors.affiliation: Department of General Practice, Maastricht University Medical Centre, School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands. patrick.vanlimpt@maastrichtuniversity.nl
authors.forename: Patrick M
authors.initials: PM
authors.lastname: van Limpt
authors.forename: Janneke
authors.initials: J
authors.lastname: Harting
authors.forename: Patricia
authors.initials: P
authors.lastname: van Assema
authors.forename: Erik
authors.initials: E
authors.lastname: Ruland
authors.forename: Arnold
authors.initials: A
authors.lastname: Kester
authors.forename: Ton
authors.initials: T
authors.lastname: Gorgels
authors.forename: J André
authors.initials: JA
authors.lastname: Knottnerus
authors.forename: Jan W
authors.initials: JW
authors.lastname: van Ree
authors.forename: Henri E
authors.initials: HE
authors.lastname: Stoffers
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016000:Cluster Analysis; D003376:Counseling; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011320:Primary Health Care; D018570:Risk Assessment; D040242:Risk Reduction Behavior