None listed
Conditions
Brief summary
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in 40+ year olds in Australia and much care is directed at dealing with the consequences of the disease at an advanced stage. Many of the risk factors (high cholesterol, high blood sugar, hypertension, obesity, inactivity, cigarette smoking) though modifiable are often undiagnosed and hence untreated. Even when diagnosed and when a treatment plan is in place, patient adherence to the treatment guidelines may not be as rigorously followed as expected. For many, the general practitioner (GP) is usually the point of first contact with the health system. GPs are well positioned to offer positive health messages and treatment options that can influence the health of their patients. This can be achieved through a combination of involving patients more in their own risk factor management and providing greater primary care support (GP and practice nurse) thereby stimulating the motivation for patients to increase their adherence to clinical guidelines. In light of this we undertook the “Fremantle Primary Prevention Study” over the last 18 months, in 1200 men and women aged 40-80 years recruited through 3 general practices in Perth. This study aims to show that while a significant proportion of the community are already known to have cardiovacular risk factors, GPs and their practice staff are ideally positioned to assess the extent of this potential morbibity and institute treatment modalities and exercise programs to reverse and modify them.
Interventions
Increased General Practitioner contact. Patients were seen at the clinic. No home visits were made. Patients were seen at baseline and then at 3,6,9 and 12 months. Patients were advised at initial consultation that they would need to be seen at 3 monthly intervals and encouraged to make their own appointment at the due date. Patients who attended opportunistically (ie for reasons other than the study) close to the follow-up date were seen at that time as part of study follow-up. In some instance
Increased General Practitioner contact. Patients were seen at the clinic. No home visits were made. Patients were seen at baseline and then at 3,6,9 and 12 months. Patients were advised at initial consultation that they would need to be seen at 3 monthly intervals and encouraged to make their own appointment at the due date. Patients who attended opportunistically (ie for reasons other than the study) close to the follow-up date were seen at that time as part of study follow-up. In some instances telephone or letter reminders were given. At baseline information booklets from the Heart Foundation on healthy living were made available to all participants as were "quit packs" for smokers. Baseline and three month follow-up involved: review of current smoking status, blood pressure, weight, body mass index (BMI), waist circumference, exercise in minutes per week for 5 days, fasting bloods for lipids and glucose, if patients were known diabetics blood tests were done for HbA1c and creatinine and urine for albumin-creatinine ratio (ACR). Cardiac, diabetic, anti-smoking and weight reduction medications were reviewed as appropriate. Advice on the importance of giving up smoking, healthy diet and exercise was also given. Referral information to allied health or other specialists were also recorded.
Sponsors
University of Notre Dame Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients presenting to a General Practitioner
Exclusion criteria
Not within age range for study Prior cardiovascular event Incapable of giving informed consent Tansient visitor Physical inability
Outcome results
None listed