Family-based interventions can help high-risk patients improve their health and prevent future cardiovascular events, according to new data published in The Lancet.
To gain a better understanding of the relationship between family support and lifestyle changes, researchers used the PROLIFIC trial to evaluate the efficacy of a family-based integrated cardiovascular risk management interventions in patients with a family history of premature coronary heart disease (CHD).
Researchers reviewed the medical records of 750 patients with CHD who were treated from January 2015 to April 2017. Sixty-six percent of patients were women, and the mean patient age was 40.8 years old.
In the analysis, 368 families (with a total of 825 participants) were assigned to the intervention group, and 382 families (with 846 participants) were assigned to the usual care group.
According to the authors, at the two-year follow-up, 807 (98%) of 825 participants in the intervention group and 822 (97%) of 846 participants in the "usual care" group were available for follow-up.
Patients in the intervention group were given a package of interventions facilitated by non-physician health workers including: screening for cardiovascular risk factors; structured lifestyle interventions; linkage to a primary health-care facility for individuals with established chronic disease risk factors or conditions; and active follow-up for adherence.
The "usual care" group were given one-time counseling and annual screening for risk factors.
The primary outcome of the study was the percentage of patients achieving or maintaining any three of the following four conditions:
- Blood pressure lower than 140/90 mm Hg;
- Fasting blood glucose less than 110 mg/dL (<6·1 mmol/L);
- Low-density lipoprotein less than 100 mg/dL (<2·6 mmol/L);
- Abstinence from smoking or tobacco use, assessed in all participants with available data.
After two years, that endpoint was reached in 64% of patients in the intervention group and 46% of patients in the usual care group.
Non-physician healthcare workers played a key role, carrying out a median of 13 visits to each family in the intervention group over the course of the study,
“Our study shows that a family-based approach can promote the adoption of lifestyle changes to reduce cardiovascular risk in high-risk families,” wrote lead author Panniyammakal Jeemon, PhD, of Sree Chitra Tirunal Institute of Medical Sciences and Technology in India, and colleagues. “The moderate reduction in multiple risk factors as result of the family-based intervention cumulatively yields significant reductions in cardiovascular risk and might prevent future cardiovascular events at the population level.”
Read the full study here.