Holt, Tim A., Thorogood, Margaret, Griffiths, Frances and Munday, Stephen (2006) Protocol for the 'e-Nudge trial' : a randomised controlled trial of electronic feedback to reduce the cardiovascular risk of individuals in general practice [ISRCTN64828380]. Trials, Vol.28 . pp. 7-11. doi:10.1186/1745-6215-7-11 ISSN 1745-6215.

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Abstract

Background: Cardiovascular disease (including coronary heart disease and stroke) is a major
cause of death and disability in the United Kingdom, and is to a large extent preventable, by lifestyle
modification and drug therapy. The recent standardisation of electronic codes for cardiovascular
risk variables through the United Kingdom's new General Practice contract provides an
opportunity for the application of risk algorithms to identify high risk individuals. This randomised
controlled trial will test the benefits of an automated system of alert messages and practice
searches to identify those at highest risk of cardiovascular disease in primary care databases.
Design: Patients over 50 years old in practice databases will be randomised to the intervention
group that will receive the alert messages and searches, and a control group who will continue to
receive usual care. In addition to those at high estimated risk, potentially high risk patients will be
identified who have insufficient data to allow a risk estimate to be made. Further groups identified
will be those with possible undiagnosed diabetes, based either on elevated past recorded blood
glucose measurements, or an absence of recent blood glucose measurement in those with
established cardiovascular disease.
Outcome measures: The intervention will be applied for two years, and outcome data will be
collected for a further year. The primary outcome measure will be the annual rate of cardiovascular
events in the intervention and control arms of the study. Secondary measures include the
proportion of patients at high estimated cardiovascular risk, the proportion of patients with missing
data for a risk estimate, and the proportion with undefined diabetes status at the end of the trial.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Library of Congress Subject Headings (LCSH):	Cardiovascular system -- Diseases -- Treatment -- Great Britain
Journal or Publication Title:	Trials
Publisher:	Biomed Central
ISSN:	1745-6215
Official Date:	28 April 2006
Dates:	Date Event 28 April 2006 Published
Volume:	Vol.28
Page Range:	pp. 7-11
DOI:	10.1186/1745-6215-7-11
Status:	Peer Reviewed
Access rights to Published version:	Open Access (Creative Commons)
Description:	Final version (as published).

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