IMPROVING HEALTH BEHAVIOR AND OUTCOMES AFTER ANGIOPLASTY

描述（改编自研究者摘要）：本随机试验的主要目的是比较两种策略在刺激行为改变和改善两年结局、无心肌梗死、卒中、II-IV级心绞痛或严重缺血的无创生存率方面的有效性，这些患者接受了血管成形术或冠状动脉支架手术。将评估一种新的行为干预是否更有效地降低死亡率和主要心血管疾病的发病率比标准的风险降低方法，这是一个机会，以避免未来的发病率和死亡率的风险。这种新的战略是基于净现值的经济理论。共660例完成血管成形术或支架植入术的患者将入组。 净现值和标准治疗组都将接受基线风险评估。 在这两个群体中，健康风险行为变化的潜在领域是相同的：体育活动，吸烟，饮食，血压和药物。 对照组患者将接受标准的术后方法，其中包括显示他们在14个选定的心血管风险因素方面的概况，相对于每个因素的标准。 他们将被要求选择2-3种行为来改变，以增加他们的寿命。 实验组患者将收到他们当前的生物学年龄或基于他们的风险状况的“真实的年龄”。 他们将被要求选择2-3种行为来改变，以降低他们的生物学年龄，并显示如果保持3个月和如果保持2年，每种行为对生物学年龄的影响。 在试验的维持阶段，患者将每三个月接受一次随访，每次随访时将更新其风险因素概况。 净现值组将收到其更新的生物年龄，对照组将收到其更新的风险因素概况。最终结果将在两年后进行评估。本试验旨在测试净现值方法在改善血管成形术或冠状动脉支架植入术后的健康行为和长期结局方面的有效性。 本研究的长期目标是确定是否净现值方法激励行为改变是有效的，在改善治疗结果，提高生活质量的一组高危患者。

DESCRIPTION (adapted from investigator's abstract): The principal objective of this randomized trial is to compare the effectiveness of two strategies for motivating behavioral change and improving two-year outcomes, survival free from myocardial infarction, stroke, Class II-IV angina or severe ischemia on non-invasive testing, among patients who have undergone angioplasty or coronary artery stent procedures. The will evaluate whether a novel behavioral intervention based on individualized feedback of risk profiles framed as the opportunity to reduce one's biologic age is more effective in reducing mortality and major cardiovascular morbidity than the standard risk reduction approach, which is framed as the opportunity to avoid future risk of morbidity and mortality. This new strategy is based on the economic theory of net-present value. A total of 660 patients who have completed angioplasty or stenting will be enrolled. Both the net-present value and standard treatment groups will receive a baseline risk evaluation. In both groups the potential areas for health risk behavior change are identical: physical activity, smoking, diet, blood pressure and medications. Control group patients will receive the standard post-procedure approach, which will include being shown their profile on 14 selected cardiovascular risk factors, relative to norms on each factor. They will be asked to choose 2-3 behaviors to change to increase their life span. Experimental group patients will receive their current biological age or "real age" based on their risk profile. They will be asked to choose 2-3 behaviors to change to reduce their biological age and shown the impact each behavior would have on biological age if maintained for 3 months and if maintained for 2 years. During the trial's maintenance phase, patients will be followed every three months, and at each follow-up will have their risk factor profile updated. The net- present value group will receive their updated biological age, and the control group will receive their updated risk factor profile. Final outcomes will be evaluated at two years. This trial is designed to test the effectiveness of the net-present value approach to improving health behavior and long-term outcomes after angioplasty or coronary artery stenting. The long-term objective of this study is to determine whether a net-present value approach for motivating behavior change is effective in improving treatment outcomes, and enhancing quality of life among a group of high-risk patients.