title: Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care.
abstract: BACKGROUND
  Treatment goals for cardiovascular risk management are generally not achieved. Specialized practice nurses are increasingly facilitating the work of general practitioners and self-monitoring devices have been developed as counseling aid. The aim of this study was to compare standard treatment supported by self-monitoring with standard treatment without self-monitoring, both conducted by practice nurses, on cardiovascular risk and separate risk factors.
  
  
  METHODS
  Men aged 50-75 years and women aged 55-75 years without a history of cardiovascular disease or diabetes, but with a SCORE 10-year risk of cardiovascular mortality ≥ 5% and at least one treatable risk factor (smoking, hypertension, lack of physical activity or overweight), were randomized into two groups. The control group received standard treatment according to guidelines, the intervention group additionally received pro-active counseling and self-monitoring (pedometer, weighing scale and/ or blood pressure device). After one year treatment effect on 179 participants was analyzed.
  
  
  RESULTS
  SCORE risk assessment decreased 1.6% (95% CI 1.0-2.2) for the control group and 1.8% (1.2-2.4) for the intervention group, difference between groups was .2% (-.6-1.1). Most risk factors tended to improve in both groups. The number of visits was higher and visits took more time in the intervention group (4.9 (SD2.2) vs. 2.6 (SD1.5) visits p< .001 and 27 (P25 -P75:20-33) vs. 23 (P25 -P75:19-30) minutes/visit p= .048).
  
  
  CONCLUSIONS
  In both groups cardiovascular risk decreased significantly after one year of treatment by practice nurses. No additional effect of basing the pro-active counseling on self-monitoring was found, despite the extra time investment.
  
  
  BACKGROUND
  trialregister.nl NTR2188.
authors.affiliation: Department General Practice, University Medical Centre, Groningen, the Netherlands. a.h.tiessen@umcg.nl
authors.forename: Ans H
authors.initials: AH
authors.lastname: Tiessen
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Smit
authors.forename: Jan
authors.initials: J
authors.lastname: Broer
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Meer
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000517:prevention & control / Q000628:therapy; D002318:Cardiovascular Diseases / Q000517:prevention & control / Q000628:therapy*; D003376:Counseling; D005260:Female; D058006:General Practice; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D059017:Primary Care Nursing; D018570:Risk Assessment; D012307:Risk Factors; D012308:Risk Management; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires