Impact of a cardiovascular disease risk screening result on preventive behaviour in asymptomatic participants of the ROBINSCA trial

Eur J Prev Cardiol. 2019 Aug;26(12):1313-1322. doi: 10.1177/2047487319843396. Epub 2019 Apr 9.

Abstract

Introduction: A teachable moment for preventive behavioural change can occur when asymptomatic individuals receive their cardiovascular disease screening result. This study investigated prevention-seeking behaviour and compliance with preventive treatment of participants of the population-based Risk Or Benefit IN Screening for CArdiovascular disease (ROBINSCA) trial after receiving a screening result.

Methods: Asymptomatic Dutch individuals (n = 43,447) were randomly assigned (1:1:1) to screening for cardiovascular disease by either traditional risk assessment (intervention arm A), or determining the amount of coronary artery calcification (intervention arm B), or to usual care (control arm). A random sample (n = 600) of ROBINSCA participants with a screening result (arms A and B) received an online questionnaire (in 2017) to measure the impact of a cardiovascular disease screening result in low and increased (arm A: risk > 10%; arm B: Agatston ≥ 100) risk groups.

Results: Of all respondents (438/600; 73%) 63.5% were men and the mean age ( ± standard deviation) was 63.8 ± 6.9 years. Individuals with an increased coronary artery calcification score consulted their general practitioner more often compared to increased risk individuals from arm A: 140/149 (94%) and 86/137 (62.8%), respectively (P < 0.001). Current use of blood pressure and cholesterol-lowering drugs was significantly higher in the increased coronary artery calcification score group (108/140; 77.1%), compared to the group with an increased traditional risk (35/80, 43.8%; P < 0.001). Self-reported compliance was high (98.1-100%).

Conclusion: Receiving the screening result might be a teachable moment that can enhance cardiovascular disease prevention-seeking behaviour through consulting a general practitioner and high compliance with preventive treatment. The impact of the screening result was more profound in the increased coronary artery calcification score group. Trial registration number: NTR6471.

Keywords: Cardiovascular disease; attitudes; coronary disease; health knowledge; mass screening; practice; randomised controlled trial; treatment adherence and compliance.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Asymptomatic Diseases
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / psychology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Medication Adherence*
  • Middle Aged
  • Netherlands
  • Patient Education as Topic*
  • Predictive Value of Tests
  • Preventive Health Services*
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Hypolipidemic Agents