Implementing guidelines to routinely prevent chronic vascular disease in primary care: the preventive evidence into practice cluster randomised controlled trial

Fort Harris, Mark, Parker, Sharon M., Litt, John, Van Driel, Mieke, Russell, Grant, Mazza, Danielle, Jayasinghe, Upali W., Del Mar, Chris, Lloyd, Jane, Smith, Jane, Zwar, Nicholas, Taylor, Richard, Powell Davies, Gawaine, Denney-Wilson, Elizabeth, Laws, Rachel, Snowdon, Teri, Bolger-Harris, Helen, Groombridge, Stephan, Goldstein, Stan, Howarth, Teresa, Huang, Nancy and Wilson, Jinty 2015, Implementing guidelines to routinely prevent chronic vascular disease in primary care: the preventive evidence into practice cluster randomised controlled trial, BMJ open, vol. 5, no. 12, pp. 1-11, doi: 10.1136/bmjopen-2015-009397.

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Title Implementing guidelines to routinely prevent chronic vascular disease in primary care: the preventive evidence into practice cluster randomised controlled trial
Author(s) Fort Harris, Mark
Parker, Sharon M.
Litt, John
Van Driel, Mieke
Russell, Grant
Mazza, Danielle
Jayasinghe, Upali W.
Del Mar, Chris
Lloyd, Jane
Smith, Jane
Zwar, Nicholas
Taylor, Richard
Powell Davies, Gawaine
Denney-Wilson, Elizabeth
Laws, RachelORCID iD for Laws, Rachel orcid.org/0000-0003-4328-1116
Snowdon, Teri
Bolger-Harris, Helen
Groombridge, Stephan
Goldstein, Stan
Howarth, Teresa
Huang, Nancy
Wilson, Jinty
Journal name BMJ open
Volume number 5
Issue number 12
Start page 1
End page 11
Total pages 11
Publisher BMJ
Place of publication London, Eng.
Publication date 2015
ISSN 2044-6055
Summary Objective: To evaluate an intervention to improve implementation of guidelines for the prevention of chronic vascular disease. Setting: 32 urban general practices in 4 Australian states. Randomisation: Stratified randomisation of practices. Participants: 122 general practitioners (GPS) and practice nurses (PNs) were recruited at baseline and 97 continued to 12 months. 21 848 patient records were audited for those aged 40-69 years who attended the practice in the previous 12 months without heart disease, stroke, diabetes, chronic renal disease, cognitive impairment or severe mental illness. Intervention: The practice level intervention over 6 months included small group training of practice staff, feedback on audited performance, practice facilitation visits and provision of patient education and referral information. Outcome measures: Primary: 1. Change in proportion of patients aged 40-69 years with smoking status, alcohol intake, body mass index (BMI), waist circumference (WC), blood pressure (BP) recorded and for those aged 45-69 years with lipids, fasting blood glucose and cardiovascular risk in the medical record. 2. Change in the level of risk for each factor. Secondary: change in self-reported frequency and confidence of GPS and PNs in assessment. Results: Risk recording improved in the intervention but not the control group for WC (OR 2.52 (95% CI 1.30 to 4.91)), alcohol consumption (OR 2.19 (CI 1.04 to 4.64)), smoking status (OR 2.24 (1.17 to 4.29)) and cardiovascular risk (OR 1.50 (1.04 to 2.18)). There was no change in recording of BP, lipids, glucose or BMI and no significant change in the level of risk factors based on audit data. The confidence but not reported practices of GPS and PNs in the intervention group improved in the assessment of some risk factors. Conclusions: This intervention was associated with improved recording of some risk factors but no change in the level of risk at the follow-up audit. Trial registration number: Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000578808, results.
Language eng
DOI 10.1136/bmjopen-2015-009397
Field of Research 110699 Human Movement and Sports Science not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, BMJ
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082582

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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