Your browser doesn't support javascript.
loading
Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management.
Iturralde, Esti; Sterling, Stacy A; Uratsu, Connie S; Mishra, Pranita; Ross, Thekla B; Grant, Richard W.
Afiliación
  • Iturralde E; Division of Research Kaiser Permanente Northern California Oakland CA.
  • Sterling SA; Division of Research Kaiser Permanente Northern California Oakland CA.
  • Uratsu CS; Division of Research Kaiser Permanente Northern California Oakland CA.
  • Mishra P; Division of Research Kaiser Permanente Northern California Oakland CA.
  • Ross TB; Division of Research Kaiser Permanente Northern California Oakland CA.
  • Grant RW; Division of Research Kaiser Permanente Northern California Oakland CA.
J Am Heart Assoc ; 8(23): e014021, 2019 12 03.
Article en En | MEDLINE | ID: mdl-31787053
Background Despite the success of current cardiovascular disease (CVD) management programs, many patients do not achieve optimal control of CVD-related risk factors. New strategies are needed to better activate and engage these patients. Methods and Results We conducted a parallel, 2-arm, randomized controlled trial, CREATE Wellness (Changing Results-Engage and Activate to Enhance Wellness) from February 2015 to September 2017 with 12-month follow-up to September 2018. Eligible participants had ≥1 uncontrolled CVD risk factors (hyperlipidemia, hypertension, or diabetes mellitus) for at least 2 years before study enrollment. The control group (n=315) received usual care within an existing CVD population-based disease management program. The intervention group (n=332) received usual care plus a group-based behavioral intervention focused on patient activation and engagement. Study outcomes included patient activation and patient-centered care processes (6 months) and healthcare system engagement, medication adherence, and control of CVD risk factors (12 months). Compared with the control group at follow-up, the intervention group had greater improvement in patient activation (adjusted mean difference=2.8, P=0.01), patient-centered care (adjusted mean difference=0.19, P=0.003), and 2 out of 3 measures of healthcare system engagement (eg, secure messages exchanged with a population health manager; adjusted incidence rate ratio=1.7, P=0.01). Intervention and control arms did not differ on improvement in 1-year CVD risk factor control. Conclusions Further work is needed to more effectively connect increased patient activation and engagement to downstream changes in risk factor control. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02302612.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Atención Dirigida al Paciente / Atención a la Salud / Automanejo Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Atención Dirigida al Paciente / Atención a la Salud / Automanejo Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido