Efectividad de una estrategia de intervención preventiva, basada en entrevistas telefónicas estructuradas, en una población laboral con riesgo cardiovascular moderado/alto.


Autoria(s): Cabrera Sierra, Martha; Calvo Bonacho, Eva; García García, Ángel; Ruiz Moraga, Montserrat; Sáinz Gutiérrez, Juan Carlos; Chama Barrientos, Antonio; Sánchez-Chaparro, Miguel Ángel
Data(s)

20/06/2014

20/06/2014

01/10/2010

Resumo

OBJECTIVE This study assesses the effectiveness of a structured telephone survey on cardiovascular prevention, in modifying lifestyle, on cardiovascular risk parameters, percentage of smoking cessation and overall cardiovascular risk (CVR). DESIGN Quasi-experimental study of preventive intervention. SETTING Ibermutuamur (Spanish Accident and Health Insurance Company). Centres established throughout Spain. PARTICIPANTS A total of 4,792 workers with moderate/high cardiovascular risk who had agreed to be contacted by phone. Subjects with a previous diagnosis of cardiovascular disease and those receiving treatment for hypertension, hypercholesterolemia or diabetes were excluded. INTERVENTION A final total of 3,085 workers were contacted and were followed up by telephone surveys on the first, fourth and eighth month after the initial check up (CU) in order to emphasise cardiovascular health advice (Group A); we failed to contact 1,707 workers, who only attended the baseline and one year CUs (Group B). PRINCIPAL OUTCOMES: CUs included medical records and physical examination, with two blood pressure measurements, Body Mass Index (BMI), and biochemical parameters. Cardiovascular risk was stratified following the European cardiovascular SCORE. Individuals with a relative risk higher than 4 were also considered as high-risk. All workers were informed about their cardiovascular risk profile (CVRF) and healthy cardiovascular lifestyle measures. They were also given a letter for their General Practitioner (GP) to inform them on the worker's cardiovascular risk level. RESULTS A total of 71.5% of the workers were over 45 years, 95.0% males, 76.6% manual workers ("Blue Collar") and 69.7% smokers. Both groups showed improvement in lipid parameters, blood pressure, smoking cessation and overall cardiovascular risk in the second CU. There were significant differences in favour of Group A as regards blood pressure, lipids (except HDL cholesterol), BMI, glycaemia, smoking cessation (A: 23.5%/B: 19.44%, P=0.001) and CVR stratum improvement (A: 46.6%/B: 37.7%, P=0.0001). The large majority (85%) of workers read preventive recommendations; 33% knew their risk level and 73% knew their CVRF. 52.9% gave the letter to the GP, which led them to start therapies on diet (47%), hypertension (19.5%), dyslipidaemia (16.7%), diabetes (4.4%) and smoking (2.9%) and no changes were made in 36.5% of cases. CONCLUSIONS The results of this study suggests that cardiovascular prevention strategy based on structured telephone surveys on high/moderate CVR subjects to promote lifestyle changes could be effective at reducing CVR. A clinical trial is required for confirmation. Sending information on CVRF following routine medial CUs and Primary Care involvement, could contribute to the positive changes observed.

English Abstract; Journal Article;

Identificador

Sierra MC, Bonacho EC, García ÁG, Moraga MR, Gutiérrez JC, Barrientos AC, et al. Efectividad de una estrategia de intervención preventiva, basada en entrevistas telefónicas estructuradas, en una población laboral con riesgo cardiovascular moderado/alto. Aten Primaria. 2010; 42(10):498-505

1578-1275 (Online)

0212-6567 (Print)

http://hdl.handle.net/10668/1638

20851506

10.1016/j.aprim.2010.05.003

Idioma(s)

es

Publicador

Elsevier España (Elsevier Doyma)

Relação

Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria

http://zl.elsevier.es/es/revista/atencion-primaria-27/resumen/efectividad-una-estrategia-intervencion-preventiva-13156084

Direitos

Acceso abierto

Palavras-Chave #Cardiovascular risk #Telephone survey #Lifestyle #Preventive medicine #Occupational medicine #Primary care #Riesgo cardiovascular #Encuesta telefónica #Estilos de vida #Medicina preventiva #Medicina del trabajo #Atención primaria #Medical Subject Headings::Diseases::Cardiovascular Diseases #Medical Subject Headings::Check Tags::Female #Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Interviews as Topic #Medical Subject Headings::Check Tags::Male #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged #Medical Subject Headings::Health Care::Population Characteristics::Health::Occupational Health #Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Primary Prevention #Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Risk Factors #Medical Subject Headings::Information Science::Information Science::Communications Media::Telecommunications::Telephone #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Artículo