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[The effect of general practitioners' advice to men with increased risk of ischemic heart disease]
1Aarhus Universitet, Institut for Almen Medicin.
Insights
General practitioners' advice did not improve health behaviors in men at risk for ischemic heart disease (IHD). Improvements observed were attributed to the Hawthorn effect and natural regression to the mean.
Area of Science:
- Cardiology
- Preventive Medicine
- General Practice
Context:
- Ischemic heart disease (IHD) poses a significant health risk, particularly for middle-aged men.
- General practitioners (GPs) play a crucial role in preventive healthcare and risk factor management.
- Assessing the efficacy of GP interventions is vital for optimizing cardiovascular health strategies.
Purpose:
- To evaluate the impact of GP-delivered advice on modifying risk factors for IHD in at-risk men.
- To determine if targeted health talks and risk-score-based advice lead to measurable improvements in cardiovascular health behaviors.
- To differentiate the effects of specific interventions from placebo effects like the Hawthorn effect or regression to the mean.
Summary:
- A multipractice study involving 65 GPs provided health advice to 169 men (40-49 years) at increased IHD risk.
- A control group of 125 men with moderate IHD risk also underwent assessment.
- After six months, both groups showed similar decreases in IHD risk factors, suggesting the intervention had no additional benefit.
Impact:
- GP advice alone did not significantly alter health behaviors or reduce IHD risk factors beyond placebo effects.
- Findings highlight the need for more robust interventions to effectively manage cardiovascular risk in primary care settings.
- The study underscores the importance of considering psychological factors like the Hawthorn effect in health intervention research.
Abstract:
The aim of the present study was to investigate the result of general practitioners' advice to men with increased risk of ischaemic heart disease (IHD). The study was a multipractice study with 65 general practitioners in the county of Aarhus. The intervention group included 169 40-49 year-old men with high and increased risk of IHD, 125 men with a moderate risk of IHD were selected as the control group. The intervention was a health talk and advice based on the men's individual risk-score for IHD. Six months after the examination the effect of the intervention was evaluated as change in the men's risk-score for IHD. There was a significant decrease in the incidence of risk factors for IHD in both the intervention and the control group, but the decrease was the same in the two groups. The conclusion of the study is that the change in the risk factors and the risk-score for IHD was mainly due to the Hawthorn effect and regression towards the mean. The general practitioners' advice had no additional effect on the men's health behaviour.