Objective: The epidemic of obesity is contributing to the increasing prevalence of people at high risk of cardiovascular disease (CVD), negating the medical advances in reducing CVD mortality. We compared the clinical and cost-effectiveness of an intensive lifestyle intervention consisting of enhanced motivational interviewing in reducing weight and increasing physical activity for patients at high risk of CVD.
Methods: A three-arm, single-blind, parallel-group randomised controlled trial was conducted in consenting primary care centres in south London. We recruited patients aged 40-74 years with a QRisk2 score ≥20.0%, which indicates the probability of having a CVD event in the next 10 years. The intervention was enhanced motivational interviewing which included additional behaviour change techniques and was delivered by health trainers in 10 sessions over 1 year, in either group (n=697) or individual (n=523) format. The third arm received usual care (UC; n=522). The primary outcomes were physical activity (mean steps/day) and weight (kg). Secondary outcomes were changes in low-density lipoprotein cholesterol and CVD risk score. We estimated the relative cost-effectiveness of each intervention.
Results: At 24 months, the group and individual interventions were not more effective than UC in increasing physical activity (mean difference=70.05 steps, 95% CI -288.00 to 147.90 and mean difference=7.24 steps, 95% CI -224.01 to 238.50, respectively), reducing weight (mean difference=-0.03 kg, 95% CI -0.49 to 0.44 and mean difference=-0.42 kg, 95% CI -0.93 to 0.09, respectively) or improving any secondary outcomes. The group and individual interventions were not cost-effective at conventional thresholds.
Conclusions: Enhancing motivational interviewing with additional behaviour change techniques was not effective in reducing weight or increasing physical activity in those at high CVD risk.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057797 | PMC |
| http://dx.doi.org/10.1136/heartjnl-2019-315656 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Short and mid-term research priorities for Veterans with multiple sclerosis: A modified Delphi process engaging Veterans, researchers, and operational partners.
Mult Scler Relat Disord
January 2025
Multiple Sclerosis Center of Excellence West, Veterans Affairs, USA; Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, Washington, 98108, USA; Department of Rehabilitation Medicine, University of Washington, 325 9th Avenue, Seattle, Washington, 98104, USA. Electronic address:
Background/objective: Identifying research priorities of Veterans, MS researchers, and key stakeholders is critical to advance high-quality, evidence-based, and Veteran-specific MS care.
Methods: We used a modified Delphi approach to identify research priorities for Veterans with MS. Electronic surveys were distributed to Veterans with MS (n = 50,975), MS researchers (n = 191), VA healthcare providers (1,337), and funding agency representatives (n = 6) asking about their 2-3 most important research questions that would benefit Veterans with MS for researchers to answer in the next 5-10 years.
Phosphodiesterase inhibition restoreshypoxia-induced cerebrovascular dysfunction subsequent to improved systemic redox homeostasis: A randomized, double-blind, placebo-controlled crossover study.
J Cereb Blood Flow Metab
January 2025
Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
To what extent sildenafil, a selective inhibitor of the type-5 phosphodiesterase modulates systemic redox status and cerebrovascular function during acute exposure to hypoxia remains unknown. To address this, 12 healthy males (aged 24 ± 3 y) participated in a randomized, placebo-controlled crossover study involving exposure to both normoxia and acute (60 min) hypoxia (Fi = 0.14), followed by oral administration of 50 mg sildenafil and placebo (double-blinded).
View Article and Find Full Text PDFSustained effects of bladder point-of-care ultrasound simulation exercise on nursing students: A prospective cohort study.
BMC Med Educ
January 2025
School of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
Background: Point-of-care ultrasound (POCUS) can be used in a variety of clinical settings and is a safe and powerful tool for ultrasound-trained healthcare providers, such as physicians and nurses; however, the effectiveness of ultrasound education for nursing students remains unclear. This prospective cohort study aimed to examine the sustained educational impact of bladder ultrasound simulation among nursing students.
Methods: To determine whether bladder POCUS simulation exercises sustainably improve the clinical proficiency regarding ultrasound examinations among nursing students, evaluations were conducted before and after the exercise and were compared with those after the 1-month follow-up exercise.
Research on the application effect of self-transcendence nursing model in patients with gestational diabetes mellitus: a randomised controlled trial.
BMC Pregnancy Childbirth
January 2025
Editorial Board of Jiangsu Medical Journal, the First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China.
Background: Gestational diabetes mellitus is hyperglycemia in special populations (pregnant women), however gestational diabetes mellitus (GDM) not only affects maternal health, but also has profound effects on offspring health. The prevalence of gestational diabetes in my country is gradually increasing.
Objective: To study the application effect of self-transcendence nursing model in GDM patients.
Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden.
BMC Prim Care
January 2025
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Aims: To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC).
Methods: We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!