Evidence map›Paper›PMID 26534729›Full record

ArticleBMJ open2015

Six-year follow-up of the SPHERE RCT: secondary prevention of heart disease in general practice.

A W Murphy, M E Cupples, E Murphy, J Newell, C J Scarrott, A Vellinga, P Gillespie, M Byrne, C Kearney, S M Smith

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Long-term cost effectiveness of cardiac secondary prevention in primary care in the Republic of Ireland and Northern Ireland.The European journal of health economics : HEPAC : health economics in prevention and care · 2017
    Trial
  2. Article
  3. Article
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

10 authors at 5 institutions in 2 countries.

A W MurphyDiscipline of General Practice, National University of Ireland, Galway, Ireland.
M E CupplesUKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, Northern Ireland.
E MurphyDiscipline of General Practice, National University of Ireland, Galway, Ireland.
J NewellHealth Research Board Clinical Research Facility, National University of Ireland, Galway, Ireland.
C J ScarrottSchool of Mathematic and Statistics, University of Canterbury, Christchurch, New Zealand.
A VellingaDiscipline of General Practice, National University of Ireland, Galway, Ireland.
P GillespieSchool of Business and Economics, National University of Ireland, Galway, Ireland.
M ByrneSchool of Psychology, National University of Ireland, Galway, Ireland.
C KearneyDiscipline of General Practice, National University of Ireland, Galway, Ireland.
S M SmithDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
National University of Ireland · IEOllscoil na Gaillimhe – University of Galway · IEHealth Research Board · IERoyal College of Surgeons in Ireland · IEUniversity of Canterbury · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the long-term effectiveness of a complex intervention in primary care aimed at improving outcomes for patients with coronary heart disease.

designA 6-year follow-up of a cluster randomised controlled trial, which found after 18 months that both total and cardiovascular hospital admissions were significantly reduced in intervention practices (8% absolute reduction).

setting48 general practices in the Republic of Ireland and Northern Ireland.

participants903 patients with established coronary heart disease at baseline in the original trial.

interventionThe original intervention consisted of tailored practice and patient plans; training sessions for practitioners in medication prescribing and behavioural change; and regular patient recall system. Control practices provided usual care. Following the intervention period, all supports from the research team to intervention practices ceased. OUTCOME MEASURES: PRIMARY OUTCOME: hospital admissions, all cause and cardiovascular; secondary outcomes: mortality; blood pressure and cholesterol control.

resultsAt 6-year follow-up, data were collected from practice records of 696 patients (77%). For those who had died, we censored their data at the point of death and cause of death was established. There were no significant differences between the intervention and control practices in either total (OR 0.83 (95% CI 0.54 to 1.28)) or cardiovascular hospital admissions (OR 0.91 (95% CI 0.49 to 1.65)). We confirmed mortality status of 886 of the original 903 patients (98%). There were no significant differences in mortality (15% in intervention and 16% in control) or in the proportions of patients above target control for systolic blood pressure or total cholesterol.

conclusionsInitial significant differences in the numbers of total and cardiovascular hospital admissions were not maintained at 6 years and no differences were found in mortality or blood pressure and cholesterol control. Policymakers need to continue to assess the effectiveness of previously efficacious programmes. TRIAL REGISTRATION NUMBER: Current Controlled Trials ISRCTN24081411.

Indexed as

General PracticeSecondary PreventionCoronary DiseaseFollow-Up StudiesHospitalizationHumansHypercholesterolemiaHypertensionIrelandNorthern IrelandOutcome Assessment, Health Care

Identifiers

PMID26534729
PMCPMC4636612
OpenAlexW1907061493

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.