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Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial
Karianne Svendsen1,2, David R Jacobs3, Lisa T Mørch-Reiersen4
1Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Insights
Using a
Area of Science:
- Cardiovascular disease risk assessment and communication.
- Public health interventions in community pharmacy settings.
- Biomarker analysis for lifestyle changes.
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality globally.
- Effective communication of CVD risk is crucial for motivating lifestyle changes.
- The 'heart age' tool estimates an individual's CVD risk based on risk factors.
Purpose of the Study:
- To evaluate if 'heart age' communication enhances motivation for healthier lifestyles.
- To assess the impact of 'heart age' on whole-blood cholesterol and omega-3 status.
- To explore pharmacy staff perceptions of the 'heart age' tool's utility.
Main Methods:
- Cluster-randomized trial in 48 community pharmacies.
- Intervention group received 'heart age' plus conventional risk communication.
- Control group received conventional risk communication only.
- Whole-blood cholesterol and omega-3 fatty acids measured via dried blood spots at baseline and 4 weeks.
- Pharmacy staff surveyed on perceived utility of the 'heart age' tool.
Main Results:
- No significant difference in cholesterol reduction between intervention and control groups.
- Omega-3 fatty acid concentrations increased similarly in both groups after 4 weeks.
- Pharmacy staff found the 'heart age' tool convenient and motivating for communicating CVD risk.
Conclusions:
- While perceived as a motivating tool by pharmacy staff, 'heart age' communication did not improve cholesterol or omega-3 status more than conventional methods.
- Further research may be needed to optimize the use of 'heart age' for clinical outcomes.
- Community pharmacies can play a role in CVD risk communication, but the added value of 'heart age' requires further investigation.
Background:
Joint British Societies have developed a tool that utilizes information on cardiovascular disease (CVD) risk factors to estimate an individual's 'heart age'. We studied if using heart age as an add-on to conventional risk communication could enhance the motivation for adapting to a healthier lifestyle resulting in improved whole-blood cholesterol and omega-3 status after 4 weeks.
Methods:
A total of 48 community pharmacies were cluster-randomized to use heart age+conventional risk communication (intervention) or only conventional risk communication (control) in 378 subjects after CVD risk-factor assessment. Dried blood spots were obtained with a 4-week interval to assay whole-blood cholesterol and omega-3 fatty acids. We also explored pharmacy-staff's (n=27) perceived utility of the heart age tool.
Results:
Subjects in the intervention pharmacies (n=137) had mean heart age 64 years and chorological age 60 years. In these, cholesterol decreased by median (interquartile range) -0.10 (-0.40, 0.35) mmol/l. Cholesterol decreased by -0.20 (-0.70, 0.30) mmol/l (P difference =0.24) in subjects in the control pharmacies (n=120) with mean chronological age 60 years. We observed increased concentrations of omega-3 fatty acids after 4 weeks, non-differentially between groups. Pharmacy-staff (n=27) agreed that heart age was a good way to communicate CVD risk, and most (n=25) agreed that it appeared to motivate individuals to reduce elevated CVD risk factors.
Conclusions:
The heart age tool was considered a convenient and motivating communication tool by pharmacy-staff. Nevertheless, communicating CVD risk as heart age was not more effective than conventional risk communication alone in reducing whole-blood cholesterol levels and improving omega-3 status.
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