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N/A N=401 Randomized Single-blind Health Services Research

Randomized Controlled Trial of Group Prevention Coaching

Cardiovascular Disease

Enrolled (actual)
401
Serious AEs
0.3%
Results posted
May 2020
Primary outcome: Primary: Risk of Fatal Coronary Event or Non-fatal MI — 27.0; 26.3 percent risk of major cv event in 10 yrs — p=0.50

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Problem Solving (Behavioral)
Age
Adult, Older Adult · 21+ yrs
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Oct 2018

Outcome Measures

OutcomeResultp-value
PRIMARY
Risk of Fatal Coronary Event or Non-fatal MI
25.7; 28.2
SECONDARY
Patient Activation Measure
62.1; 62.6
SECONDARY
Risk of Fatal Coronary Event or Non-fatal MI
25.7; 28.2

Summary

Prevention of cardiovascular disease is a primary focus of the Secretary's New Models of Care Transformational Initiative. However, prevention has been hard to accomplish. The VA is committed to using group visits to address a wide array of primary care problems. Coaching is a method to help Veterans set and reach health goals by helping them overcome barriers to behavior change. Coaching can be performed one-on-one or in groups. This study will test the effectiveness of a group prevention coaching (GPC) intervention in improving cardiovascular risk. GPCs will focus on changing a behavior of the patient's choice that is likely to lead to improvements in heart disease risk. The coach will adopt a problem-solving approach to helping Veterans make these improvements. The primary outcome will be change in 10-year risk of major cardiac event; the investigators will also assess improvements in food choice, physical activity and weight.

Eligibility Criteria

Inclusion Criteria

  • A diagnosis of inadequately controlled hypertension, as defined by an outpatient ICD-9 code of 401.x and a most recent blood pressure with either systolic > 140 mmHg or diastolic > 90 mmHg
  • OR (2) inadequately controlled dyslipidemia, as defined by most recent total cholesterol > 200 mg/dl or HDL cholesterol < 35 mg/dl
  • OR (3) current smoking, which can be identified using the CPRS Health Factor tied to the smoking clinical reminder.
  • Medication-taking status for these illnesses is neither required nor excluded.

Exclusion Criteria

  • Subjects with very high risk of cardiovascular event, as determined by any personal history of coronary artery disease (CAD) or other major cardiovascular disease (ICD-9 code of 410-414, or 425-429)
  • cerebrovascular disease (code 433-438)
  • peripheral arterial disease (codes 440.x or 443.x)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01838226). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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