Support for Patient-Centered Cardiovascular Risk Counseling With Two Components of the DECADE Intervention.
Background: Health-conscious behavior can help prevent cardiovascular diseases. The DECADE intervention ("decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases") is designed to support primary care physicians in cardiovascular risk co...
| Publicado en: | Deutsches Ärzteblatt International Vol. 122; no. 25; pp. 687 - 695 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Deutscher Aerzte-Verlag GmbH
12/12/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191413381&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191413381 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 12/12/2025 vid: 122 iid: 25 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 191413381 10.3238/arztebl.m2025.0203 191413381 ppf: 687 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: C tig: atl: Support for Patient-Centered Cardiovascular Risk Counseling With Two Components of the DECADE Intervention. aug: au: Tinsel, I Schmoor, C Börger, M Kamp, M Hardt, H Rakebrandt, A Kloppe, T Gräfe, W Kutter, S Riemenschneider, H Maun, A affil: Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany sug: ab: Background: Health-conscious behavior can help prevent cardiovascular diseases. The DECADE intervention ("decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases") is designed to support primary care physicians in cardiovascular risk counseling. We studied the effects of two of its components. Methods: A trial with a cluster-randomized 2 x 2 design was conducted in three regions of Germany (registration number DRKS00025401). 76 primary care physicians who were randomly allocated to one of four study arms recruited a total of 797 patients with lifestyle-related cardiovascular risk factors. 712 of them were included in the analysis. Cardiovascular risk was calculated for all patients at the start of the intervention and at 12 months. The control group (CG) underwent usual treatment; intervention group (IG) 1 received DECADE patient materials; IG2 had patient-centered DECADE follow-up consultations (at week 1, at months 3, 6, and 12; and additionally at month 9, if necessary); and IG3 received both of these DECADE intervention components. The primary endpoint was the self-reported change in patient activation (Patient Activation Measure, PAM13) at month 6. The secondary endpoints were changes in health behavior and clinical parameters. Linear mixed regression models were used to analyze the effects of DECADE follow-up consultations (IG2 + IG3) versus no follow-up consultations (CG + IG1), and of DECADE materials (IG1 + IG3) versus no materials (CG + IG2), according to the 2 x 2 design. Results: DECADE follow-up consultations (compared to none) had a small positive, statistically significant effect on the primary endpoint PAM13 score of 1.14 points (95% confidence interval (CI): [0.09; 2.19], p = 0.033). The effect of DECADE patient materials (compared to none) was 0.30 (95% CI: [-0.75; 1.35], p = 0.57). Patients in all study arms showed improved health behavior. Conclusion: Although the demonstrated effect on the PAM13 score is of uncertain clinical relevance, other findings of this trial imply that DECADE may effectively support physicians in cardiovascular risk counseling. A long-term trial of its clinical effects is recommended. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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