Larsen Lars Bruun, Sonderlund Anders Larrabee, Sondergaard Jens, Thomsen Janus Laust, Halling Anders, Hvidt Niels Christian, Hvidt Elisabeth Assing, Mønsted Troels, Pedersen Line Bjornskov, Roos Ewa M, Pedersen Pia Vivian, Thilsing Trine
Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Lund, Sweden.
BMC Fam Pract. 2018 Jul 21;19(1):124. doi: 10.1186/s12875-018-0820-8.
The consequences of lifestyle-related disease represent a major burden for the individual as well as for society at large. Individual preventive health checks to the general population have been suggested as a mean to reduce the burden of lifestyle-related diseases, though with mixed evidence on effectiveness. Several systematic reviews, on the other hand, suggest that health checks targeting people at high risk of chronic lifestyle-related diseases may be more effective. The evidence is however very limited. To effectively target people at high risk of lifestyle-related disease, there is a substantial need to advance and implement evidence-based health strategies and interventions that facilitate the identification and management of people at high risk. This paper reports on a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care designed to systematically identify persons at risk of developing lifestyle-related disease or who engage in health-risk behavior, and provide targeted and coherent preventive services to these individuals.
The intervention took place over a three-month period from September 2016 to December 2016. Taking a two-pronged approach, the design included both a joint and a targeted intervention. The former was directed at the entire population, while the latter specifically focused on patients at high risk of a lifestyle-related disease and/or who engage in health-risk behavior. The intervention was facilitated by a digital support system. The evaluation of the pilot will comprise both quantitative and qualitative research methods. All outcome measures are based on validated instruments and aim to provide results pertaining to intervention acceptability, feasibility, and short-term effects.
This pilot study will provide a solid empirical base from which to plan and implement a full-scale randomized study with the central aim of determining the efficacy of a preventive health intervention.
Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016 ). Registered 29 April 2016. The study adheres to the SPIRIT guidelines.
生活方式相关疾病的后果给个人以及整个社会都带来了重大负担。有人建议对普通人群进行个体预防性健康检查,以此作为减轻生活方式相关疾病负担的一种手段,不过关于其有效性的证据并不一致。另一方面,多项系统评价表明,针对慢性生活方式相关疾病高危人群的健康检查可能更有效。然而,相关证据非常有限。为了有效地针对生活方式相关疾病高危人群,迫切需要推进并实施基于证据的健康策略和干预措施,以促进对高危人群的识别和管理。本文报告了一项非随机试点研究,该研究旨在测试一项初级保健中的医疗干预措施的可接受性、可行性和短期效果,该干预措施旨在系统地识别有患生活方式相关疾病风险或从事健康风险行为的人,并为这些个体提供有针对性且连贯的预防服务。
干预从2016年9月至2016年12月为期三个月。采用双管齐下的方法,设计包括联合干预和针对性干预。前者针对全体人群,而后者特别关注生活方式相关疾病高危人群和/或从事健康风险行为的患者。该干预由一个数字支持系统提供便利。试点评估将包括定量和定性研究方法。所有结果指标均基于经过验证的工具,旨在提供与干预可接受性、可行性和短期效果相关的结果。
这项试点研究将提供坚实的实证基础,据此规划和实施一项全面的随机研究,其核心目标是确定预防性健康干预的效果。
在Clinical Trial Gov注册(唯一方案识别号:TOFpilot2016)。于2016年4月29日注册。该研究遵循SPIRIT指南。