Evidence map›Paper›PMID 22141447›Full record

Trial reportBMC health services research2011

A randomized trial of an intervention to improve use and adherence to effective coronary heart disease prevention strategies.

Stacey L Sheridan, Lindy B Draeger, Michael P Pignone, Thomas C Keyserling, Ross J Simpson, Barbara Rimer, Shrikant I Bangdiwala, Jianwen Cai, Ziya Gizlice

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  4. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
    Pooled it
  5. Decision coaching for people making healthcare decisions.The Cochrane database of systematic reviews · 2021
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  7. Guideline
  8. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017
    Pooled it
  9. Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Stacey L SheridanDivision of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, NC, USA. sls593@med.unc.edu.
Lindy B Draeger
Michael P Pignone
Thomas C Keyserling
Ross J Simpson
Barbara Rimer
Shrikant I Bangdiwala
Jianwen Cai
Ziya Gizlice

Funding

UNIV OF NORTH CAROLINA CLINICAL NUTRITION RESEARCH UNITP30DK056350 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SUSAN M. SMITH · 1999 to 2026
$31.6M
Decision Aid to Enhance CHD Risk Factor ModificationK23HL074375 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SHERIDAN, STACEY L · 2005 to 2009
$774k
Improving Cancer-Related Patient Decision MakingK05CA129166 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI PIGNONE, MICHAEL P · 2008 to 2012
$765k
NCI NIH HHS K05 CA129166NHLBI NIH HHS 1 K23 HL074375NHLBI NIH HHS K23 HL074375NIDDK NIH HHS DK 56350
6 · The paper itself

Abstract

backgroundEfficacious strategies for the primary prevention of coronary heart disease (CHD) are underused, and, when used, have low adherence. Existing efforts to improve use and adherence to these efficacious strategies have been so intensive that they are impractical for clinical practice.

methodsWe conducted a randomized trial of a CHD prevention intervention (including a computerized decision aid and automated tailored adherence messages) at one university general internal medicine practice. After obtaining informed consent and collecting baseline data, we randomized patients (men and women age 40-79 with no prior history of cardiovascular disease) to either the intervention or usual care. We then saw them for two additional study visits over 3 months. For intervention participants, we administered the decision aid at the primary study visit (1 week after baseline visit) and then mailed 3 tailored adherence reminders at 2, 4, and 6 weeks. We assessed our outcomes (including the predicted likelihood of angina, myocardial infarction, and CHD death over 10 years (CHD risk) and self-reported adherence) between groups at 3 month follow-up. Data collection occurred from June 2007 through December 2009. All study procedures were IRB approved.

resultsWe randomized 160 eligible patients (81 intervention; 79 control) and followed 96% to study conclusion. Mean predicted CHD risk at baseline was 11.3%. The intervention increased self-reported adherence to chosen risk reducing strategies by 25 percentage points (95% CI 8% to 42%), with the biggest effect for aspirin. It also changed predicted CHD risk by -1.1% (95% CI -0.16% to -2%), with a larger effect in a pre-specified subgroup of high risk patients.

conclusionA computerized intervention that involves patients in CHD decision making and supports adherence to effective prevention strategies can improve adherence and reduce predicted CHD risk.

Indexed as

Patient ComplianceAdultAgedCoronary DiseaseFeasibility StudiesFemaleHumansMaleMiddle AgedPrimary PreventionSelf ReportUnited States

Identifiers

PMID22141447
PMCPMC3268742

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.