Evidence map›Paper›PMID 36981949›Full record

Trial reportInternational journal of environmental research and public health2023

The Effect and Cost-Effectiveness of Offering a Combined Lifestyle Intervention for the Prevention of Cardiovascular Disease in Primary Care: Results of the Healthy Heart Stepped-Wedge Trial.

Emma A Nieuwenhuijse, Rimke C Vos, Wilbert B van den Hout, Jeroen N Struijs, Sanne M Verkleij, Karin Busch, Mattijs E Numans, Tobias N Bonten

Open access · goldFull text readClinical Trial
In one paragraph

Trial report in International journal of environmental research and public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.3field-weighted citation impact, top 13% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. 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

8 authors at 1 institution in 1 country.

Emma A NieuwenhuijseHealth Campus the Hague, Leiden University Medical Center, 2511 DP The Hague, The Netherlands.ORCID 0000-0003-3277-4003
Rimke C VosHealth Campus the Hague, Leiden University Medical Center, 2511 DP The Hague, The Netherlands.ORCID 0000-0003-1074-6255
Wilbert B van den HoutDepartment of Medical Decision Making, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Jeroen N StruijsHealth Campus the Hague, Leiden University Medical Center, 2511 DP The Hague, The Netherlands.
Sanne M VerkleijHealth Campus the Hague, Leiden University Medical Center, 2511 DP The Hague, The Netherlands.
Karin BuschHadoks Chronische Zorg BV, 2517 JK The Hague, The Netherlands.
Mattijs E NumansHealth Campus the Hague, Leiden University Medical Center, 2511 DP The Hague, The Netherlands.
Tobias N BontenDepartment of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.ORCID 0000-0002-7719-6182
Leiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effectiveness and cost-effectiveness of offering the combined lifestyle programme "Healthy Heart", addressing overweight, diet, physical activity, smoking and alcohol, to improve lifestyle behaviour and reduce cardiovascular risk.

designA practice-based non-randomised stepped-wedge cluster trial with two-year follow-up. Outcomes were obtained via questionnaires and routine care data. A cost-utility analysis was performed. During the intervention period, "Healthy Heart" was offered during regular cardiovascular risk management consultations in primary care in The Hague, The Netherlands. The period prior to the intervention period served as the control period.

resultsIn total, 511 participants (control) and 276 (intervention) with a high cardiovascular risk were included (overall mean ± SD age 65.0 ± 9.6; women: 56%). During the intervention period, 40 persons (15%) participated in the Healthy Heart programme. Adjusted outcomes did not differ between the control and intervention period after 3-6 months and 12-24 months. Intervention versus control (95% CI) 3-6 months: weight: β -0.5 (-1.08-0.05); SBP β 0.15 (-2.70-2.99); LDL-cholesterol β 0.07 (-0.22-0.35); HDL-cholesterol β -0.03 (-0.10-0.05); physical activity β 38 (-97-171); diet β 0.95 (-0.93-2.83); alcohol OR 0.81 (0.44-1.49); quit smoking OR 2.54 (0.45-14.24). Results were similar for 12-24 months. Mean QALYs and mean costs of cardiovascular care were comparable over the full study period (mean difference (95% CI) QALYs: -0.10 (-0.20; 0.002); costs: EUR 106 (-80; 293)).

conclusionsFor both the shorter (3-6 months) and longer term (12-24 months), offering the Healthy Heart programme to high-cardiovascular-risk patients did not improve their lifestyle behaviour nor cardiovascular risk and was not cost-effective on a population level.

Indexed as

Cardiovascular DiseasesAgedCholesterol, LDLCost-Benefit AnalysisFemaleHumansLife StyleMiddle AgedPrimary Health CareCholesterol, LDLcardiovascular riskcost effectivenesslifestyle factorspreventative health careprimary practice

Identifiers

PMID36981949
PMCPMC10048996
OpenAlexW4324062078

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read53
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.