The effect of a self-management intervention to reduce vascular risk factors in patients with manifestations of vascular diseases.

ABSTRACT

BACKGROUND: Self-management can improve health behaviors and influence reduction of vascular risk. We developed a 1-year self-management intervention and investigated its effect on vascular risk factors and quality of life in patients with different vascular diseases. DESIGN AND METHODS: This observational cohort study involved 223 patients (self-management group, n=125; usual care group n=98) with at least two modifiable vascular risk factors. RESULTS: Patients in the self-management group achieved treatment goals for LDL-cholesterol (difference 13%; 95%CI 1-26) and HDL-cholesterol (difference 9% 95%CI 0-19) significantly more often than did patients in the usual care group. Mean systolic blood pressure decreased significantly by 5mm Hg (95%CI -9 to 0) in the self-management group and mean BMI increased significantly by 0.4 kg/m(2) (95%CI -0.8 to -0.1) in the usual care group. No significant differences were seen in waist circumference, smoking, or triglycerides. General health (RAND36) improved more in the self-management group (by 8 points 95%CI 3-12) than in the usual care group. CONCLUSION: After 1 year, the self-management intervention was more effective than usual care on several important vascular risk factors in patients with vascular diseases. PRACTICE IMPLICATIONS This self-management intervention used in a hospital population may be applicable in different care settings.