A Randomized Controlled Trial of a Novel Community-based Primary and Secondary Cardiovascular Prevention Program

This study has been completed.
Sponsor:
Collaborators:
Ontario Ministry of Health and Long Term Care
McMaster University
Coalition for the Acquisition of Sound Habits
Ministry of Northern Development and Mines Youth Internship Program
Pfizer
Information provided by:
Group Health Centre
ClinicalTrials.gov Identifier:
NCT00236210
First received: October 7, 2005
Last updated: July 31, 2009
Last verified: July 2009
  Purpose

VIP is a demonstration project with a goal to decrease modifiable risk factors for those with a higher risk of having a vascular event such as a heart attack or stroke or of developing vascular disease. Introduced as a study, VIP compares whether there is a significant reduction of modifiable vascular risk factors among patients who are involved in a personalized directed program versus those being provided standard care by their physician. Health care providers work collaboratively with the 'VIP Team' to improve the participants' vascular health.


Condition Intervention
Vascular Disease
Diabetes
Hypertension
Hyperlipidemia
Obesity
Behavioral: Action Score
Behavioral: VIP program

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: The Vascular Intervention Project (VIP): a Randomized Controlled Trial of a Novel Community-based Primary and Secondary Cardiovascular Prevention Program in the Algoma District of Northern Ontario

Resource links provided by NLM:


Further study details as provided by Group Health Centre:

Primary Outcome Measures:
  • The percentage of patients who attained a significant reduction in their global cardiovascular risk at 6 and 12 months. This was determined a priori by the investigators to be an increase in the ACTION Score of 5 or more. [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Secondary outcomes were change in the average ACTION Score, change in individual risk domains as measured by the ACTION Score, patient satisfaction, and quality of life, all after 6 months and 12 months, comparing intervention versus control. [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]

Enrollment: 422
Study Start Date: August 2004
Study Completion Date: July 2006
Primary Completion Date: July 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: VIP program
Risk assessment, lifestyle counselling, exercise program
Behavioral: Action Score
Improvement in a novel 100-point score summarizing cardiovascular risk.
Behavioral: VIP program
Risk assessment, lifestyle counselling, exercise program
No Intervention: Standard Care

Detailed Description:

This Northern Ontario, community-based demonstration project is a multi-disciplinary, primary care provider-based collaboration. The goals of the project are to:

  1. Decrease the modifiable risk factors for primary care patients at risk for vascular disease in the Algoma District;
  2. Increase collaboration between health care providers such as family physicians, pharmacists, physiotherapists, dietitians and nurses in the community;
  3. Increase the participation of the patient and family in decision-making, self-care, and adherence to agreed-upon management plans;
  4. Improve patient access to care, clinical outcomes and satisfaction;
  5. Provide a business case for a practical, sustainable and generalizable model for the primary care of vascular disease in the community.

The Group Health Centre, a multi-disciplinary, not-for-profit community-based health organization with 56,000 rostered patients, leads the project. However, all Sault Ste Marie community patients are eligible to join the Vascular Intervention Program (VIP). This program has three key components: a registry of VIP patients with audit, recall and feedback; use of the novel ACTION score template, and the optional use of VIPNet, a personalized patient record tool that provides secure web access to optimize quality and continuity of care. The VIP project aims to empower patients and increase collaboration among the primary health care team. Patients with any vascular risk factors will be eligible for VIP.

The VIP project is a demonstration project that does not duplicate existing GHC chronic disease management programs because (1) the VIP is offered to all eligible community patients, not only GHC enrollees; (2) VIP integrates any patients with vascular risk, not just those with pre-defined conditions; (3) novel collaborative tools such as the ACTION template and VIPNet website are being piloted; and (4) explicit patient-centred decision making drives the process. The development and evaluation of the VIP demonstration project is a unique step in the evolution of primary care chronic disease management in Sault Ste Marie, and the rest of the province.

  Eligibility

Ages Eligible for Study:   30 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men >30 years of age
  • Women > 40 years of age
  • History of vascular disease (as defined in Study Design, page 8)
  • Framingham Risk Score >/= 12 %
  • Capable of giving informed consent
  • Ability and willingness to complete questionnaires and have study procedures done
  • Willingness to belong to either the intervention or standard care arm

Exclusion Criteria:

  • FRS <12% (low risk) -- enrolled into the cohort arm (not randomized. Follow-up at study end only.)
  • Any condition that will prevent the patient from participating in and completing the study
  • Unable to come to the Group Health Centre for appointments
  • Any factor likely to limit protocol compliance
  • Unwilling to permit VIP staff to contact their primary physicians to communicate information about the study and the participant's data and treatment assignment
  • Previous randomization into this study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00236210

Locations
Canada, Ontario
Group Health Centre
Sault Ste. Marie, Ontario, Canada, P6B 1Y5
Sponsors and Collaborators
Group Health Centre
Ontario Ministry of Health and Long Term Care
McMaster University
Coalition for the Acquisition of Sound Habits
Ministry of Northern Development and Mines Youth Internship Program
Pfizer
Investigators
Principal Investigator: David Crookston, MD CCFP Algoma District Medical Group and Group Health Centre
  More Information

Additional Information:
No publications provided

Responsible Party: Dr. David Crookston, Group Health Centre
ClinicalTrials.gov Identifier: NCT00236210     History of Changes
Other Study ID Numbers: Go3-03031
Study First Received: October 7, 2005
Last Updated: July 31, 2009
Health Authority: Canada: Health Canada

Keywords provided by Group Health Centre:
Vascular Intervention Program
Vascular Disease
Coronary Artery Disease
Diabetes
Lifestyle Modification
Modifiable Risk Factors

Additional relevant MeSH terms:
Diabetes Mellitus
Hyperlipidemias
Hypertension
Obesity
Vascular Diseases
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Dyslipidemias
Lipid Metabolism Disorders
Cardiovascular Diseases
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Signs and Symptoms

ClinicalTrials.gov processed this record on July 28, 2014