The PROPRESE trial : results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention
Copyright © 2014 Elsevier España, S.L. All rights reserved..
OBJECTIVE: Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care.
METHODS: In this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed.
RESULTS: The characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C < 100mg/dL (46.9%); SBP < 140mmHg (64.5%); DBP < 90 (91.2%). The multivariable analysis showed the risk of good control for intervention group to be: smoking, adjusted relative risk (aRR): 15.70 (95% confidence interval [95%CI], 4.2-58.7); P < .001; LDL-C, aRR: 2.98 (95%CI, 1.48-6.02); P < .002; SPB, aRR: 1.97 (95%CI, 1.21-3.23); P < .007, and DBP: aRR: 1.51 (95%CI, 0.65-3.50); P < .342.
CONCLUSIONS: An intervention based on models for chronic patients focused in primary care and involving patients in medical decision making improves cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 Suppl 3 |
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| Enthalten in: |
Atencion primaria - 46 Suppl 3(2014) vom: 01. Juni, Seite 10-5 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
El estudio PROPRESE: resultados de un nuevo modelo organizativo en atención primaria para pacientes con cardiopatía isquémica crónica basado en una intervención multifactorial |
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| Links: |
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| Anmerkungen: |
Date Completed 29.09.2016 Date Revised 21.10.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1016/S0212-6567(14)70060-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM242283330 |
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| 245 | 1 | 4 | |a The PROPRESE trial |b results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention |
| 246 | 3 | 3 | |a El estudio PROPRESE: resultados de un nuevo modelo organizativo en atención primaria para pacientes con cardiopatía isquémica crónica basado en una intervención multifactorial |
| 264 | 1 | |c 2014 | |
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| 500 | |a Date Completed 29.09.2016 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 Elsevier España, S.L. All rights reserved. | ||
| 520 | |a OBJECTIVE: Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care | ||
| 520 | |a METHODS: In this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed | ||
| 520 | |a RESULTS: The characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C < 100mg/dL (46.9%); SBP < 140mmHg (64.5%); DBP < 90 (91.2%). The multivariable analysis showed the risk of good control for intervention group to be: smoking, adjusted relative risk (aRR): 15.70 (95% confidence interval [95%CI], 4.2-58.7); P < .001; LDL-C, aRR: 2.98 (95%CI, 1.48-6.02); P < .002; SPB, aRR: 1.97 (95%CI, 1.21-3.23); P < .007, and DBP: aRR: 1.51 (95%CI, 0.65-3.50); P < .342 | ||
| 520 | |a CONCLUSIONS: An intervention based on models for chronic patients focused in primary care and involving patients in medical decision making improves cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Atención primaria | |
| 650 | 4 | |a Cardiovascular diseases | |
| 650 | 4 | |a Enfermedades cardiovasculares | |
| 650 | 4 | |a Health services research | |
| 650 | 4 | |a Investigación en servicios sanitarios | |
| 650 | 4 | |a Prevención secundaria | |
| 650 | 4 | |a Primary care | |
| 650 | 4 | |a Secondary prevention | |
| 700 | 1 | |a Orozco-Beltran, Domingo |e verfasserin |4 aut | |
| 700 | 1 | |a Gaubert-Tortosa, María |e verfasserin |4 aut | |
| 700 | 1 | |a Navarro-Palazón, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Cordero-Fort, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Navarro-Pérez, Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Carratalá-Munuera, Concepción |e verfasserin |4 aut | |
| 700 | 1 | |a Pertusa-Martínez, Salvador |e verfasserin |4 aut | |
| 700 | 1 | |a Soler-Bahilo, Enrique |e verfasserin |4 aut | |
| 700 | 1 | |a Brotons-Muntó, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Bort-Cubero, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Núñez-Martínez, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Bertomeu-Martínez, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a López-Pineda, Adriana |e verfasserin |4 aut | |
| 700 | 1 | |a Gil-Guillén, Vicente F |e verfasserin |4 aut | |
| 700 | 0 | |a en nombre de los investigadores del Proyecto PROPRESE |e verfasserin |4 aut | |
| 700 | 1 | |a Mabel Prina, Adriana |e investigator |4 oth | |
| 700 | 1 | |a González Timoneda, Alba |e investigator |4 oth | |
| 700 | 1 | |a Cordero Fort, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Bonet Plá, Álvaro |e investigator |4 oth | |
| 700 | 1 | |a Andrés Pruñonosa, Amparo |e investigator |4 oth | |
| 700 | 1 | |a Biot Giner, Amparo |e investigator |4 oth | |
| 700 | 1 | |a Chalmeta Rosaleny, Amparo |e investigator |4 oth | |
| 700 | 1 | |a García Royo, Amparo |e investigator |4 oth | |
| 700 | 1 | |a Grau Estela, Amparo |e investigator |4 oth | |
| 700 | 1 | |a Zaragozá Muñoz, Amparo |e investigator |4 oth | |
| 700 | 1 | |a Barber Moll, Ana |e investigator |4 oth | |
| 700 | 1 | |a Menero Pesudo, Ana Carmen |e investigator |4 oth | |
| 700 | 1 | |a Navarro Palazón, Ana Isabel |e investigator |4 oth | |
| 700 | 1 | |a Melian Noguera, Ana M |e investigator |4 oth | |
| 700 | 1 | |a Cabrera Rodriguez, Ana María |e investigator |4 oth | |
| 700 | 1 | |a Sanmartín Almenar, Ana |e investigator |4 oth | |
| 700 | 1 | |a Tchang Sánchez, Ana |e investigator |4 oth | |
| 700 | 1 | |a Vidal Ledesma, Ana |e investigator |4 oth | |
| 700 | 1 | |a Morales Gisbert, Angelina |e investigator |4 oth | |
| 700 | 1 | |a Pastor Monerris, Antoni |e investigator |4 oth | |
| 700 | 1 | |a Torrent Soler, Antonia |e investigator |4 oth | |
| 700 | 1 | |a Latorre, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Romero Aznar, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Aznar Montalt, Auxilio |e investigator |4 oth | |
| 700 | 1 | |a Valero Claramunt, Beatriz |e investigator |4 oth | |
| 700 | 1 | |a Montagud Carda, Blanca |e investigator |4 oth | |
| 700 | 1 | |a Cloquell Rodrigo, Blas |e investigator |4 oth | |
| 700 | 1 | |a Castañeda Zapico, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Fluixá Carrascosa, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Fenoll Palomares, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Hernández Pellicer, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Miquel Roig, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Rubio Martínez, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Vicente Sol, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Vives Casino, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Zaragozá Cardells, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Rubert Escrig, Carmina |e investigator |4 oth | |
| 700 | 1 | |a Pérez Zaragoza, César |e investigator |4 oth | |
| 700 | 1 | |a Barceló Iglesias, Concepción |e investigator |4 oth | |
| 700 | 1 | |a Carratalá Munuera, Concepción |e investigator |4 oth | |
| 700 | 1 | |a Laguarda Falomir, Concepción |e investigator |4 oth | |
| 700 | 1 | |a Concha, Mora Marqués |e investigator |4 oth | |
| 700 | 1 | |a Aguilar Abad, Consuelo |e investigator |4 oth | |
| 700 | 1 | |a Arroyo Fernandez, Consuelo |e investigator |4 oth | |
| 700 | 1 | |a García Royo, Desamparados |e investigator |4 oth | |
| 700 | 1 | |a García Cánovas, Dolores |e investigator |4 oth | |
| 700 | 1 | |a Jordá Prades, Dolores |e investigator |4 oth | |
| 700 | 1 | |a Larrey Aliaga, Dolores |e investigator |4 oth | |
| 700 | 1 | |a Guinot, Domingo |e investigator |4 oth | |
| 700 | 1 | |a Orozco Beltrán, Domingo |e investigator |4 oth | |
| 700 | 1 | |a Giménez Esteban, Elena |e investigator |4 oth | |
| 700 | 1 | |a López Acuña, Elena |e investigator |4 oth | |
| 700 | 1 | |a Fernández Ripoll, Elisa |e investigator |4 oth | |
| 700 | 1 | |a Medina Ferrer, Elisa |e investigator |4 oth | |
| 700 | 1 | |a Ferré Tortosa, Elvira |e investigator |4 oth | |
| 700 | 1 | |a Quelle Alonso, Elvira |e investigator |4 oth | |
| 700 | 1 | |a Ramis Ortega, Emilia |e investigator |4 oth | |
| 700 | 1 | |a Segarra Mestre, Encarna |e investigator |4 oth | |
| 700 | 1 | |a Guinot Martinez, Enrique |e investigator |4 oth | |
| 700 | 1 | |a Soler Bahilo, Enrique |e investigator |4 oth | |
| 700 | 1 | |a Diaz Garcia, Estela |e investigator |4 oth | |
| 700 | 1 | |a Lara Fonfría, Esther |e investigator |4 oth | |
| 700 | 1 | |a Ruescas Escolano, Esther |e investigator |4 oth | |
| 700 | 1 | |a Santoro, Esther |e investigator |4 oth | |
| 700 | 1 | |a Avelino Hidalgo, Eugenia |e investigator |4 oth | |
| 700 | 1 | |a Vaquerizo, Exaltación |e investigator |4 oth | |
| 700 | 1 | |a Motilla López, Feliciano |e investigator |4 oth | |
| 700 | 1 | |a Gómez Piquer, Felin |e investigator |4 oth | |
| 700 | 1 | |a Rico Noguera, Felipe |e investigator |4 oth | |
| 700 | 1 | |a Moreno Catalá, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Ferrandiz Galvañ, Francisca |e investigator |4 oth | |
| 700 | 1 | |a Brotons Muntó, Francisco |e investigator |4 oth | |
| 700 | 1 | |a Cortés Traver, Francisco |e investigator |4 oth | |
| 700 | 1 | |a López, Francisco |e investigator |4 oth | |
| 700 | 1 | |a López Pérez, Francisco |e investigator |4 oth | |
| 700 | 1 | |a Milán Galvañ, Francisco |e investigator |4 oth | |
| 700 | 1 | |a Parra Godoy, Francisco |e investigator |4 oth | |
| 700 | 1 | |a Gallego Triviño, Gema |e investigator |4 oth | |
| 700 | 1 | |a Suarez, Goretti |e investigator |4 oth | |
| 700 | 1 | |a Durá Ballester, Hector |e investigator |4 oth | |
| 700 | 1 | |a Salla Granell, Herminia |e investigator |4 oth | |
| 700 | 1 | |a Espinosa Freire, Ildefonso |e investigator |4 oth | |
| 700 | 1 | |a Guasp Pérez, Inma |e investigator |4 oth | |
| 700 | 1 | |a Mora Garzón, Inma |e investigator |4 oth | |
| 700 | 1 | |a Rosa Mora, Inma |e investigator |4 oth | |
| 700 | 1 | |a deScalz Giménez, Inmaculada |e investigator |4 oth | |
| 700 | 1 | |a Valls García, Inmaculada |e investigator |4 oth | |
| 700 | 1 | |a Cantarino Martí, Isabel |e investigator |4 oth | |
| 700 | 1 | |a Sierra Martín, Isabel |e investigator |4 oth | |
| 700 | 1 | |a Martinez Jalvo, J Enrique |e investigator |4 oth | |
| 700 | 1 | |a Muñoz Gil, Jaime José |e investigator |4 oth | |
| 700 | 1 | |a Llopis Vicent, Javier |e investigator |4 oth | |
| 700 | 1 | |a Bleda Cano, Jesús |e investigator |4 oth | |
| 700 | 1 | |a Abad Carrasco, Joaquín |e investigator |4 oth | |
| 700 | 1 | |a Martínez Piquer, Joaquin |e investigator |4 oth | |
| 700 | 1 | |a Gallego Peris, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Navarro Perez, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Martínez Jalvo, José E |e investigator |4 oth | |
| 700 | 1 | |a Garcia Gil, José |e investigator |4 oth | |
| 700 | 1 | |a López Blasco, José Luis |e investigator |4 oth | |
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