Secondary prevention of heart disease in general practice : protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative , economic and policy analyses . [ ISRCTN 24081411 ]
Secondary prevention of heart disease in general practice : protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative , economic and policy analyses . [ ISRCTN 24081411 ]
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发表时间：
2016
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通讯作者：
Andrew W. Murphy;M. Cupples;Susan M Smith;Molly Byrne;Claire S Leathem;Molly Byrne
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作者：
Andrew W. Murphy;M. Cupples;Susan M Smith;Molly Byrne;Claire S Leathem;Molly Byrne
背景：SPHERE 研究的目的是设计、实施和评估量身定制的实践和个人护理计划，以改善爱尔兰岛两个不同卫生系统中确诊冠心病 (CHD) 患者的护理过程和客观临床结果。 CHD 是爱尔兰的常见死因和发病的重要原因。二级预防已被推荐为降低冠心病死亡率的关键策略，而一般实践已被强调为二级预防举措的理想环境。目前的迹象表明，爱尔兰岛上为患有心脏病的患者提供二级预防还有很大的改进空间。综述文献推荐了结构化的计划，并对患者进行持续的支持和随访；提供针对获得二级预防有效性证据的实践需要的培训；结构化召回计划还考虑了个人实践需求；以及以患者为中心的咨询，同时关注疾病管理指南。方法：SPHERE 是一项整群随机对照试验，在实践层面随机分为干预组和对照组，从三个研究中心（贝尔法斯特、都柏林和戈尔韦）的 48 个实践中招募了 960 名患者。主要结局是血压、总胆固醇、身心健康状况 (SF-12) 和再次入院。干预持续两年，并在基线、一年和两年随访时收集数据。数据来自医疗图表、医生咨询和患者邮寄问卷。发布日期：2005 年 7 月 29 日 Current Controlled Trials in 2005, 6:11 doi:10.1186/ 1468-6708-6-11 收稿日期：2005 年 6 月 2 日 接受日期：2005 年 7 月 29 日 本文可从以下网址获取：http://cvm.control-trials.com/content/6/1/11 © 2005墨菲等人；被许可人 BioMed Central Ltd。这是一篇根据知识共享署名许可 (http://creativecommons.org/licenses/by/2.0) 条款分发的开放获取文章，允许在任何媒体上不受限制地使用、分发和复制，前提是正确引用原始作品。
Background: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. Methods: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and twoyear follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. Published: 29 July 2005 Current Controlled Trials in Cardiovascular Medicine 2005, 6:11 doi:10.1186/ 1468-6708-6-11 Received: 02 June 2005 Accepted: 29 July 2005 This article is available from: http://cvm.controlled-trials.com/content/6/1/11 © 2005 Murphy et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.