The effect of a self-management intervention to reduce vascular risk factors in patients with manifestations of vascular diseases
Received 22 April 2009; received in revised form 13 November 2009; accepted 26 November 2009. published online 31 December 2009.
Abstract
Background
Self-management can improve health behaviors and influence reduction of vascular risk. We developed a 1-year self-management intervention and investigated its effect on vascular risk factors and quality of life in patients with different vascular diseases.
Design and methods
This observational cohort study involved 223 patients (self-management group, n=125; usual care group n=98) with at least two modifiable vascular risk factors.
Results
Patients in the self-management group achieved treatment goals for LDL-cholesterol (difference 13%; 95%CI 1–26) and HDL-cholesterol (difference 9% 95%CI 0–19) significantly more often than did patients in the usual care group. Mean systolic blood pressure decreased significantly by 5mm Hg (95%CI −9 to 0) in the self-management group and mean BMI increased significantly by 0.4kg/m2 (95%CI −0.8 to −0.1) in the usual care group. No significant differences were seen in waist circumference, smoking, or triglycerides. General health (RAND36) improved more in the self-management group (by 8 points 95%CI 3–12) than in the usual care group.
Conclusion
After 1year, the self-management intervention was more effective than usual care on several important vascular risk factors in patients with vascular diseases.
Practice implications
This self-management intervention used in a hospital population may be applicable in different care settings.
aDepartment of Vascular Medicine, University Medical Center Utrecht, The Netherlands
bJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
Corresponding author. Department of Vascular Medicine, University Medical Center Utrecht, Room L.00.407 Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Tel.: +31 88 7555555; fax: +31 88 7555514.
ABSTRACT