Effectiveness of a Combined Strategy to Improve Therapeutic Compliance and Degree of Control Among Patients With Hypercholesterolaemia

NCT ID: NCT02314663

Last Updated: 2014-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

358 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2015-12-31

Brief Summary

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Background In subjects with hypercholesterolaemia, cholesterol values remain above guideline levels. One of the limiting factors to the achievement of goals in such patients is therapeutic non-adherence. The aim of this study is to assess the effectiveness of an intervention designed to improve control of hypercholesterolaemic patients, consisting of a combined strategy that would include the delivery of printed information, treatment-compliance check cards and the dispatch of text messages as complementary measures in support of the intervention at the general practitioner's practice.

Methods/Design A randomised, parallel-group clinical trial will be conducted at the family medicine outpatient facilities of eight health centres in three of Spain's Autonomous Regions, covering a total of 358 subjects aged 18 years or over with diagnosis of hypercholesterolaemia. Patients in the intervention group will be supplied with printed material with information on the disease and its management, mobile-telephone text messages with guideline summaries, reminders of forthcoming appointments and/or arrangements for making new appointments in the event of non-attendance, and self-report cards to check compliance with recommendations. Both groups -intervention and control- will receive routine recommendations from their physicians in accordance with current European clinical practice guidelines for hypercholesterolaemia and cardiovascular risk management. As regards the measurements to be made, the main variable is the proportion of subjects who attain the low density lipoprotein cholesterol levels set as a target across a follow-up period of 24 months. The secondary variables are as follows: adherence to recommendations on lifestyle and adherence to drug treatment; variation in lipid profiles and cardiovascular risk levels; appearance of cardiovascular events; physical activity; food consumption; smoking habit; anthropometric measures; blood pressure; health problems; use of hypolipidaemic agents; socio-demographic data; beliefs and expectations about preventive recommendations; and degree of satisfaction with the combined strategy.

Discussion Should this intervention prove effective, a recommendation could be issued on the application of this combined strategy to subjects with hypercholesterolaemia. It is a simple, relatively inexpensive intervention.

Detailed Description

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Conditions

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Hypercholesterolemia Medication Adherence Primary Health Care

Keywords

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hypercholesterolaemia medication adherence primary health care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention group

"COMBINED STRATEGY" (a + b + c). Participants in the intervention group will be supplied with: a) "printed matter"; b) "mobile-telephone text messages"; and, c) "self-report cards".

This group receive routine recommendations from their GPs, in accordance with current European clinical practice guidelines on the management of hypercholesterolaemia and cardiovascular risk

Group Type EXPERIMENTAL

"COMBINED STRATEGY"

Intervention Type DEVICE

Participants in the intervention group will be supplied with: a) "printed matter" containing information on the disease and its management (this will be handed out at each of the follow-up visits); b) "mobile-telephone text messages" containing guideline summaries, reminders of forthcoming appointments and/or arrangements for making new appointments in the event of non-attendance (in the periods between visits); and, c) "self-report cards" to check compliance with recommendations (across the entire follow-up).

Control group

This group receive routine recommendations from their GPs, in accordance with current European clinical practice guidelines on the management of hypercholesterolaemia and cardiovascular risk

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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"COMBINED STRATEGY"

Participants in the intervention group will be supplied with: a) "printed matter" containing information on the disease and its management (this will be handed out at each of the follow-up visits); b) "mobile-telephone text messages" containing guideline summaries, reminders of forthcoming appointments and/or arrangements for making new appointments in the event of non-attendance (in the periods between visits); and, c) "self-report cards" to check compliance with recommendations (across the entire follow-up).

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* be diagnosed with hypercholesterolaemia, as defined according to the criteria stipulated in the cardiovascular prevention guidelines of the 2009 Prevention Activities and Promotion of Health Programme (total cholesterol of 250 mg/dl or higher).
* be patients aged 18 years or over attending any of the participating health centres.

Exclusion Criteria

* any person hindered from participating in the follow-up of the proposed intervention, e.g., illiterate subjects and non-users of mobile telephones.
* any person with a physical disability or impairment which prevents him/her from attending the follow-up visits.
* any person suffering from a significant chronic organic or psychiatric disease.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto de Salud Carlos III

OTHER_GOV

Sponsor Role collaborator

Gerencia de Atención Primaria, Albacete

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ignacio Párraga-Martínez, PhD

Role: PRINCIPAL_INVESTIGATOR

Health Care Service of Castilla-La Mancha

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U; EUROASPIRE Study Group. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil. 2009 Apr;16(2):121-37. doi: 10.1097/HJR.0b013e3283294b1d.

Reference Type BACKGROUND
PMID: 19287307 (View on PubMed)

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Reference Type BACKGROUND
PMID: 19546386 (View on PubMed)

Bermingham M, Hayden J, Dawkins I, Miwa S, Gibson D, McDonald K, Ledwidge M. Prospective analysis of LDL-C goal achievement and self-reported medication adherence among statin users in primary care. Clin Ther. 2011 Sep;33(9):1180-9. doi: 10.1016/j.clinthera.2011.07.007. Epub 2011 Aug 12.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Banegas JR, Lopez-Garcia E, Dallongeville J, Guallar E, Halcox JP, Borghi C, Masso-Gonzalez EL, Jimenez FJ, Perk J, Steg PG, De Backer G, Rodriguez-Artalejo F. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J. 2011 Sep;32(17):2143-52. doi: 10.1093/eurheartj/ehr080. Epub 2011 Apr 6.

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PMID: 21471134 (View on PubMed)

Marquez Contreras E, Casado Martinez JJ, Corchado Albalat Y, Chaves Gonzalez R, Grandio A, Losada Velasco C, Obando J, de Eugenio JM, Barrera JM. [Efficacy of an intervention to improve treatment compliance in hyperlipidemias]. Aten Primaria. 2004 May 15;33(8):443-50. doi: 10.1016/s0212-6567(04)79430-5. Spanish.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Haynes RB, McKibbon KA, Kanani R, Brouwers C, Oliver T: Interventions to assist patients to follow prescriptions for medications. In: Cochrane Collaboration: Cochrane Library. Oxford: Update Software, 1998.

Reference Type BACKGROUND

Parraga-Martinez I, Rabanales-Sotos J, Lago-Deibe F, Tellez-Lapeira JM, Escobar-Rabadan F, Villena-Ferrer A, Blasco-Valle M, Ferreras-Amez JM, Morena-Rayo S, del Campo-del Campo JM, Ayuso-Raya MC, Perez-Pascual JJ. Effectiveness of a combined strategy to improve therapeutic compliance and degree of control among patients with hypercholesterolaemia: a randomised clinical trial. BMC Cardiovasc Disord. 2015 Jan 19;15:8. doi: 10.1186/1471-2261-15-8.

Reference Type DERIVED
PMID: 25599690 (View on PubMed)

Other Identifiers

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GAPALBACETE

Identifier Type: -

Identifier Source: org_study_id