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Effectiveness of nurse-delivered cardiovascular risk management in primary care: a randomised trial
Open accessAbstract
BACKGROUND: A substantial part of cardiovascular disease prevention is delivered in primary care. Special attention should be paid to the assessment of cardiovascular risk factors. According to the Dutch guideline for cardiovascular risk management, the heavy workload of cardiovascular risk management for GPs could be shared with advanced practice nurses. AIM: To investigate the clinical effectiveness of practice nurses acting as substitutes for GPs in cardiovascular risk management after 1 year of follow-up. DESIGN OF STUDY: Prospective pragmatic randomised trial. SETTING: Primary care in the south of the Netherlands. Six centres (25 GPs, six nurses) participated. METHOD: A total of 1626 potentially eligible patients at high risk for cardiovascular disease were randomised to a practice nurse group (n = 808) or a GP group (n = 818) in 2006. In total, 701 patients were included in the trial. The Dutch guideline for cardiovascular risk management was used as the protocol, with standardised techniques for risk assessment. Changes in the following risk factors after 1 year were measured: lipids, systolic blood pressure, and body mass index. In addition, patients in the GP group received a brief questionnaire. RESULTS: A larger decrease in the mean level of risk factors was observed in the practice nurse group compared with the GP group. After controlling for confounders, only the larger decrease in total cholesterol in the practice nurse group was statistically significant (P = 0.01, two-sided). CONCLUSION: Advanced practice nurses are achieving results, equal to or better than GPs for the management of risk factors. The findings of this study support the involvement of practice nurses in cardiovascular risk management in Dutch primary care.
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“Other studies have demonstrated the effectiveness of nurse-led prevention clinics in primary care compared with usual care, with greater success in secondary as opposed to primary prevention.532 -534”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [532]
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Relevance of Improving Human Resource Management in the Organization of Primary Healthcare
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Metadata
- Authors
- Voogdt-Pruis, H. R., Beusmans, G. H., Gorgels, A. P., Kester, A. D., & Van Ree, J. W.
- Affiliations
- Maastricht University Medical Centre (NL)
- Maastricht University (NL)
- Venue
- British Journal of General Practice
- Published
- 2010-01-01
- Volume
- 60
- Issue
- 570
- Pages
- 40-46
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC2801783
- OpenAlex
- W1998810223
- Cited by
- 114
- References
- 31
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 8 · 2020: 19 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 7 · 2015: 8 · 2014: 7 · 2013: 9 · 2012: 14
- FWCI
- 10.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Pfizer
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- cardiovascular risk management, advanced practice nurses, practice nurses, general practitioners, cardiovascular disease prevention, risk factor control, total cholesterol, blood pressure, body mass index, primary care, task shifting
- MeSH terms
- Aged, Cardiovascular Diseases, Family Practice, Female, Humans, Male, Middle Aged, Netherlands, Nurse Practitioners, Prospective Studies, Risk Factors, Risk Management, Treatment Outcome
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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