None listed
Conditions
Brief summary
There are no current Australian guidelines to promote screening for families experiencing premature ischaemic heart disease (PIHD), which would suggest that in Australia this is not being undertaken systematically. Without recommendations for family screening, an opportunity for targeted IHD prevention in the community is being overlooked. Targeting of primary prevention at families with a positive history could be a highly cost-effective strategy to tackle the burden of IHD in Australia. Evidence for the potential benefits and feasibility of this strategy is required to inform the development of guidelines/recommendations appropriate to the Australian population and health system. The objective of this project is to trial a primary prevention strategy targeted to families experiencing PIHD. Evidence that attendance to a general practitioner for cardiovascular risk factor assessment results in a reduction in absolute cardiovascular risk (ACR) in these first degree relatives is lacking. However we believe that advising high risk groups within the population about their risk factors is a necessary first step toward reduction of risk in these groups. Aim: This study will trial an intervention (including written and verbal advice) to prompt first degree relatives of patients with premature ischemic heart disease (PIHD) to attend their GP for a cardiovascular risk assessment, as the first step toward reduction of their absolute cardiovascular risk (ACR). Research Question: Does the provision of written and verbal advice, promoting cardiovascular risk assessment, to first-degree relatives of patients with PIHD, increase the proportion of relatives undertaking cardiovascular risk assessment in general practice? Hypothesis: Provision of written and verbal advice promoting cardiovascular risk assessment, to first-degree relatives of patients with PIHD, will result in an increase in the level of cardiovascular risk assessment undertaken from 25% to 50%.
Interventions
Patients recruited with premature heart disease are asked to identify their first degree relatives aged 18 years and over, and to provide information about the study to them personally or by mailing. The study information sheet provided to their relatives (the intervention group) explains the study and provides a brief explanation about family history of premature heart disease and cardiovascular risk factors, and the benefits of risk factor assessment. It includes a recommendation that the rela
Patients recruited with premature heart disease are asked to identify their first degree relatives aged 18 years and over, and to provide information about the study to them personally or by mailing. The study information sheet provided to their relatives (the intervention group) explains the study and provides a brief explanation about family history of premature heart disease and cardiovascular risk factors, and the benefits of risk factor assessment. It includes a recommendation that the relative make an appointment to attend their general practitioner (GP) for a cardiovascular risk assessment (without cost to them), and instruction to contact the Heart Foundation for free telephone advice about heart disease. It also includes an option for the relative to receive further advice or have any questions answered about heart disease in the form of a telephone call with either a GP or a nurse depending on participant preference.
Sponsors
The University of Adelaide
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients: hospitalised with their first premature ischaemic heart disease (PIHD) event, with the event determined as occurring before age 55 in men, and before age 65 in women. An IHD event is defined as any one of the following: non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI), unstable angina and coronary revascularisation (coronary artery bypass grafting, coronary angioplasty with or without coronary stenting). Relatives: siblings and children (18 years and over) of the patient, without diagnosed IHD, and residing in Australia, are eligible for this study.
Exclusion criteria
Excluding: patients who are terminally ill, experiencing dementia and/or other significant cognitive impairment, unable to speak English, illiterate, and any condition that their treating doctor believes warrants intensive family follow-up and intervention.
Outcome results
None listed