Evidence map›Paper›PMID 27129980›Full record

Trial reportBMC cardiovascular disorders2016

Implementation of a new guideline in cardiovascular secondary preventive care: subanalysis of a randomized controlled trial.

Stina Jakobsson, Daniel Huber, Fredrik Björklund, Thomas Mooe

Full text readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC cardiovascular disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stina JakobssonDepartment of Public Health and Clinical Medicine, Östersund, Umeå University, Umeå, Sweden. stina.jakobsson@umu.se.
Daniel HuberDepartment of Public Health and Clinical Medicine, Östersund, Umeå University, Umeå, Sweden.
Fredrik BjörklundDepartment of Public Health and Clinical Medicine, Östersund, Umeå University, Umeå, Sweden.
Thomas MooeDepartment of Public Health and Clinical Medicine, Östersund, Umeå University, Umeå, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular secondary preventive recommendations are often not reached. We investigated whether a nurse-led telephone-based follow-up could improve the implementation of a new guideline within a year after its release.

methodsIn February 2013, a new secondary preventive guideline for diabetic patients was released in the county of Jämtland, Sweden. It included a changed of the low-density lipoprotein cholesterol (LDL-C) target value from <2.5 mmol/L to <1.8 mmol/L. In the Nurse-Based Age-Independent Intervention to Limit Evolution of Disease (NAILED) trial, patients with an acute coronary syndrome, stroke, or transient ischemic attack were randomized to secondary preventive care with nurse-based telephone follow-up (intervention) or usual care (control). Patient data were obtained from the NAILED trial to study the implementation of the new LDL-C guideline by comparing telephone follow-up with usual care. The Mann-Whitney U-test was used for continuous variables, and Person's χ (2) test was used for categorical variables to assess between-group differences.

resultsOut of the 1267 patients that entered the study period, 101 intervention and 100 control patients with diabetes fulfilled the inclusion criteria and completed the study period. Before the guideline change, 96 % of the intervention patients and 70 % of the control patients reached the target LDL-C value (p < 0.001). After the guideline change, the corresponding respective proportions were 65 % and 36 % (p < 0.001). The main reason that intervention patients did not achieve the target LDL-C value was that they received full-dose treatment; for control patients, the main reason was that medication was not adjusted, for an unknown reason.

conclusionsOne year after a change in the cardiovascular secondary preventive guideline, nurse-based telephone follow-up performed better than usual care to implement the new recommendation.

trial registrationISRCTN registry; ISRCTN96595458 (date of registration 10 July 2011) and ISRCTN23868518 (date of registration 13 May 2012).

Indexed as

Guideline AdherencePractice Guidelines as TopicAgedAged, 80 and overBiomarkersCardiovascular DiseasesChi-Square DistributionCholesterol, LDLCounselingDiabetes MellitusDyslipidemiasFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleRisk FactorsBiomarkersCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsAcute coronary syndromeCardiovascular diseaseMyocardial infarctionRandomized controlled trialSecondary preventionStrokeTransient ischemic attack

Identifiers

PMID27129980
PMCPMC4851797

What Socratic holds

Textfull text, public
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.