VISA: Vascular Lifestyle-Intervention and Screening in Pharmacy
Study Details
Study Description
Brief Summary
The overall goal of the present project is to contribute to new knowledge about the effect of a low threshold population screening system for cardiovascular risk factors in Norway. Further, this project aim to study if identifying high cardiovascular risk itself may lead to beneficial changes in health behaviors such as physical activity, diet, tobacco and alcohol behavior together with reduced risk score of cardiovascular disease, across socioeconomic status. This fall, a nationwide, free screening of cardiovascular risk factors will be conducted in 150 pharmacies in Norway. All participants that consent to participate will measure full lipid-profile, blood pressure, HbA1c, body weight and height by health care providers in pharmacies. Based on their measurement levels, participants will be stratified into either a low or a high risk group. In the high risk group, participants will further be randomized to either the intervention group or one of the two control groups. Participants in the intervention group will be informed about all their measurement levels with comparison to the recommended levels. Contrary, participants randomized to the two control groups will have delayed information of their measured levels. Participants in the intervention group and the first control groups will receive general oral and written information about how to lower their measurement levels in 8 weeks. In the second control group, participants will not receive any information at the first visit. In this way the investigators may be able to isolate the effect of identifying high risk and high levels of the risk factors itself. All groups will be given a diet- and physical activity questionnaire at visit 1, and will be invited back after 8 weeks to once more perform the measurement screening and receive the same questionnaire. At visit 2, all participants will, after the measurement screening, be informed about their measured risk factors and receive information on how to lower their levels. 1 year after inclusion, all participants in the three groups will be invited back for a one-year follow up visit in pharmacy.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
One year after inclusion, all participants that were not loss to follow up, or had their consent withdrawn, were invited back to pharmacies to perform the same measurements for the third time. However, at this third visit, pharmacies were randomized 1:2 to test an additional intervention. Further, an extra blood sample, dried blood spot, was taken to measure cholesterol, HbA1c and fatty acids.
About half of the pharmacies (n=23) communicated cardiovasular disease (CVD) risk factor levels as Heart age compared to own age (British communication tool) together with tailored lifestyle advices on how to reduce elevated levels. While the other 25 pharmacies communicated CVD risk the usual way and gave general lifestyle advices on how to reduce CVD risk. 4 weeks later, all participants took dried blood spot samples at home. We will compare results from dried blood spot samples to study whether heart age and tailored lifestyle advice is more effective than general information in reducing CVD risk.
The investigators will also record social security number to make connection to central health registry as prescription registry, patient registry and cause of death registry after 2 years and 5 years.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: No information on high risk factor levels but lifestyle advice This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks |
Behavioral: No information on high risk factor levels but lifestyle advice
In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks
|
| Experimental: No information on high risk factor levels nor lifestyle advice In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline |
Behavioral: No information on high risk factor levels, nor lifestyle advice
In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels.
|
| Experimental: Information on high risk factor levels and lifestyle advice This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks |
Behavioral: Information on high risk factor levels and lifestyle advice
This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks
|
Outcome Measures
Primary Outcome Measures
- Change in ad Hoc Risk Score (Measure on a Scale From Min 4 to Max 14) [Baseline and at 8 weeks]
The (ad hoc) risk score was a summarization of points ranging from 0 (favorable measures) , 2 (slighly unfavourable) or 4 (very unfavorable measures) assigned for each of Total cholesterol, HDL-cholesterol, HbA1c, blood pressure, body mass index and age (age was included because presence of elevated cardiovascular disease risk factors is more alarming in younger age). Risk points for each risk factor was summarized into an total risk score ranging from 4 (min) to 14 (max). A total risk score of ≥4 served as inclusion criteria because it indicated moderately elevated risk of cardiovascular disease.
Secondary Outcome Measures
- 8-week Change in Total Cholesterol [At baseline and at 8 weeks]
Change in total cholesterol, from date of randomization and until the end of the follow up after 8 weeks.
Other Outcome Measures
- Effect of Heart Age and Tailord CVD Advice After 1 Year [4 weeks]
Comparing results from blood samples after 4 weeks in 23 pharmacies (enhanced CVD communication) versus 25 pharmacies (general communication of CVD risk).N
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Above18 years
-
Not pregnant or lactating
-
Not previous cardiovascular events nor treatment related to cardiovascular disease ((myocardial infarction, stroke, angina pectoris, coronary artery bypass, - Percutaneous coronary intervention, diabetes type 1 and 2)
-
No use of cholesterol lowering medication, bloodpressure lowering medication, bloodsugar lowering medication or medication related to diabetes
Exclusion Criteria:
-
Below18 years
-
Pregnant or lactating
-
Previous cardiovascular events nor treatment related to cardiovascular disease (myocardial infarction, stroke, angina pectoris, coronary artery bypass,
-
Percutaneous coronary intervention, diabetes type 1 and 2)
-
Use of cholesterol lowering medication, bloodpressure lowering medication, bloodsugar lowering medication or medication related to diabetes
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of Oslo | Oslo | P.B. 1046 Blinderen | Norway | 0317 |
Sponsors and Collaborators
- University of Oslo
- University of Tromso
- University of Minnesota
- Boots Norway AS
- Mills DA
Investigators
- Principal Investigator: Karianne Svendsen, M.Sc., University of Oslo
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2013/1660
- 39255 (NSD)
- 1660/2013
Study Results
Participant Flow
| Recruitment Details | |
|---|---|
| Pre-assignment Detail |
| Arm/Group Title | No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice |
|---|---|---|---|
| Arm/Group Description | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks No information on high risk factor levels but lifestyle advice: In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks | In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline No information on high risk factor levels, nor lifestyle advice: In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels. | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks Information on high risk factor levels and lifestyle advice: This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks |
| Period Title: Overall Study | |||
| STARTED | 185 | 199 | 198 |
| COMPLETED | 168 | 190 | 185 |
| NOT COMPLETED | 17 | 9 | 13 |
Baseline Characteristics
| Arm/Group Title | No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice | Total |
|---|---|---|---|---|
| Arm/Group Description | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks No information on high risk factor levels but lifestyle advice: In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks | In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline No information on high risk factor levels, nor lifestyle advice: In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels. | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks Information on high risk factor levels and lifestyle advice: This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks | Total of all reporting groups |
| Overall Participants | 185 | 199 | 198 | 582 |
| Age (Count of Participants) | ||||
| <=18 years |
0
0%
|
0
0%
|
0
0%
|
0
0%
|
| Between 18 and 65 years |
113
61.1%
|
124
62.3%
|
131
66.2%
|
368
63.2%
|
| >=65 years |
72
38.9%
|
75
37.7%
|
67
33.8%
|
214
36.8%
|
| Age (years) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [years] |
57.4
(14.6)
|
56.5
(15.5)
|
55.7
(14.4)
|
56.5
(14.7)
|
| Sex: Female, Male (Count of Participants) | ||||
| Female |
140
75.7%
|
136
68.3%
|
141
71.2%
|
417
71.6%
|
| Male |
45
24.3%
|
63
31.7%
|
57
28.8%
|
165
28.4%
|
| Region of Enrollment (participants) [Number] | ||||
| Norway |
185
100%
|
199
100%
|
198
100%
|
582
100%
|
| Ad hoc risk score (units on a scale) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [units on a scale] |
5.2
(1.3)
|
5.4
(1.5)
|
5.4
(1.5)
|
5.3
(1.4)
|
Outcome Measures
| Title | Change in ad Hoc Risk Score (Measure on a Scale From Min 4 to Max 14) |
|---|---|
| Description | The (ad hoc) risk score was a summarization of points ranging from 0 (favorable measures) , 2 (slighly unfavourable) or 4 (very unfavorable measures) assigned for each of Total cholesterol, HDL-cholesterol, HbA1c, blood pressure, body mass index and age (age was included because presence of elevated cardiovascular disease risk factors is more alarming in younger age). Risk points for each risk factor was summarized into an total risk score ranging from 4 (min) to 14 (max). A total risk score of ≥4 served as inclusion criteria because it indicated moderately elevated risk of cardiovascular disease. |
| Time Frame | Baseline and at 8 weeks |
Outcome Measure Data
| Analysis Population Description |
|---|
| Between groups analysis |
| Arm/Group Title | No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice |
|---|---|---|---|
| Arm/Group Description | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks No information on high risk factor levels but lifestyle advice: In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks | In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline No information on high risk factor levels, nor lifestyle advice: In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels. | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks Information on high risk factor levels and lifestyle advice: This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks |
| Measure Participants | 185 | 199 | 198 |
| Mean (95% Confidence Interval) [units on a scale] |
-0.71
|
-0.76
|
-0.36
|
| Title | 8-week Change in Total Cholesterol |
|---|---|
| Description | Change in total cholesterol, from date of randomization and until the end of the follow up after 8 weeks. |
| Time Frame | At baseline and at 8 weeks |
Outcome Measure Data
| Analysis Population Description |
|---|
| Difference between three groups. |
| Arm/Group Title | No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice |
|---|---|---|---|
| Arm/Group Description | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks No information on high risk factor levels but lifestyle advice: In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks | In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline No information on high risk factor levels, nor lifestyle advice: In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels. | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks Information on high risk factor levels and lifestyle advice: This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks |
| Measure Participants | 168 | 190 | 185 |
| Mean (95% Confidence Interval) [mmol/L] |
-0.12
|
-0.16
|
-0.08
|
| Title | Effect of Heart Age and Tailord CVD Advice After 1 Year |
|---|---|
| Description | Comparing results from blood samples after 4 weeks in 23 pharmacies (enhanced CVD communication) versus 25 pharmacies (general communication of CVD risk).N |
| Time Frame | 4 weeks |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title |
|---|
| Arm/Group Description |
Adverse Events
| Time Frame | Adverse effects were collected during the study periode (1 year and 2 months)- between start of study (september 2014) and end of study (november 2015). | |||||
|---|---|---|---|---|---|---|
| Adverse Event Reporting Description | Definition do not differ. adverse event collection was non-systematically where the subjects were adviced to contact PI or study coordinator. | |||||
| Arm/Group Title | No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice | |||
| Arm/Group Description | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline. However, they will receive general information on how to lower risk factor levels in 8 weeks No information on high risk factor levels but lifestyle advice: In this arm, participants will have delayed information on their risk factor levels, but they will receive general advices on how to lower levels in 8 weeks | In this arm, participants will not be informed about their measured levels of the different cardiovascular risk factors, nor receiving lifestyle advices at baseline No information on high risk factor levels, nor lifestyle advice: In this arm, participants will have delayed information on both their risk factor levels and general information on how to lower risk factor levels. | This arm of high risk participants will not be informed about their measured levels of the different cardiovascular risk factors at baseline, and receive general information on how to lower risk factor levels in 8 weeks Information on high risk factor levels and lifestyle advice: This arm of high risk participants will be informed about their measured levels of the different cardiovascular risk factors. They will also receive information on how to lower their levels in 8 weeks | |||
All Cause Mortality |
||||||
| No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/185 (0%) | 0/199 (0%) | 0/198 (0%) | |||
Serious Adverse Events |
||||||
| No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/185 (0%) | 0/199 (0%) | 0/198 (0%) | |||
Other (Not Including Serious) Adverse Events |
||||||
| No Information on High Risk Factor Levels But Lifestyle Advice | No Information on High Risk Factor Levels Nor Lifestyle Advice | Information on High Risk Factor Levels and Lifestyle Advice | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/185 (0%) | 0/199 (0%) | 0/198 (0%) | |||
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
| Name/Title | Karianne Svendsen |
|---|---|
| Organization | University of Oslo |
| Phone | +4795026445 |
| karianne.svendsen@medisin.uio.no |
- 2013/1660
- 39255 (NSD)
- 1660/2013