PMID- 36828650
OWN - NLM
STAT- MEDLINE
DCOM- 20230228
LR  - 20231120
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 2
DP  - 2023 Feb 24
TI  - Does problem-based learning improve patient empowerment and cardiac risk factors 
      in patients with coronary heart disease in a Swedish primary care setting? A 
      long-term prospective, randomised, parallel single randomised trial (COR-PRIM).
PG  - e065230
LID - 10.1136/bmjopen-2022-065230 [doi]
LID - e065230
AB  - OBJECTIVES: To investigate long-term effects of a 1-year problem-based learning 
      (PBL) on self-management and cardiac risk factors in patients with coronary heart 
      disease (CHD). DESIGN: A prospective, randomised, parallel single centre trial. 
      SETTINGS: Primary care settings in Sweden. PARTICIPANTS: 157 patients with stable 
      CHD completed the study. Subjects with reading and writing impairments, mental 
      illness or expected survival less than 1 year were excluded. INTERVENTION: 
      Participants were randomised and assigned to receive either PBL (intervention) or 
      home-sent patient information (control group). In this study, participants were 
      followed up at baseline, 1, 3 and 5 years. PRIMARY AND SECONDARY OUTCOMES: 
      Primary outcome was patient empowerment (Swedish Coronary Empowerment Scale, 
      SWE-CES) and secondary outcomes General Self-Efficacy Scale (GSES), self-rated 
      health status (EQ-VAS), high-density lipoprotein cholesterol (HDL-C), body mass 
      index (BMI), weight and smoking. Outcomes were adjusted for sociodemographic 
      factors. RESULTS: The PBL intervention group resulted in a significant improved 
      change in SWE-CES over the 5-year period (mean (M), 39.39; 95% CI 37.88 to 40.89) 
      compared with the baseline (M 36.54; 95% CI 35.40 to 37.66). PBL intervention 
      group increased HDL-C level (M 1.39; 95% CI 1.28 to 1.50) compared with baseline 
      (M 1.24; 95% CI 1.15 to 1.33) and for EQ-VAS (M 77.33; 95% CI 73.21 to 81.45) 
      compared with baseline (M 68.13; 95% CI 63.66 to 72.59) while these outcomes 
      remained unchanged in the control group. There were no significant differences in 
      BMI, weight or scores on GSES, neither between nor within groups over time. The 
      overall proportion of smokers was significantly higher in the control group than 
      in the experimental group. CONCLUSION: One-year PBL intervention had positive 
      effect on patient empowerment, health status and HDL-C at a 5-year follow-up 
      compared with the control group. PBL education aiming to improve patient 
      empowerment in cardiac rehabilitation should account for sociodemographic 
      factors. TRIAL REGISTRATION NUMBER: NCT01462799.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Andreae, Christina
AU  - Andreae C
AUID- ORCID: 0000-0002-1482-767X
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden christina.andreae@liu.se.
AD  - Centre for Clinical Research Sormland, Uppsala University, Eskilstuna, Sweden.
FAU - Tingstrom, Pia
AU  - Tingstrom P
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden.
FAU - Nilsson, Staffan
AU  - Nilsson S
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden.
AD  - Primary Health Care Center Vikbolandet, Region Ostergotland, Vikbolandet, Sweden.
FAU - Jaarsma, Tiny
AU  - Jaarsma T
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden.
AD  - Julius Center, University Medical Center Utrecht, Utrecht, Netherlands.
FAU - Karlsson, Nadine
AU  - Karlsson N
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden.
FAU - Karner Kohler, Anita
AU  - Karner Kohler A
AD  - Department of Health, Medicine and Caring Sciences, Linkoping University, 
      Linkoping, Sweden.
LA  - eng
SI  - ClinicalTrials.gov/NCT01462799
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20230224
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Humans
MH  - Sweden
MH  - *Problem-Based Learning
MH  - Patient Participation
MH  - Prospective Studies
MH  - *Coronary Disease/rehabilitation
MH  - Risk Factors
MH  - Primary Health Care/methods
MH  - Cost-Benefit Analysis
PMC - PMC9972427
OTO - NOTNLM
OT  - Coronary heart disease
OT  - EDUCATION & TRAINING (see Medical Education & Training)
OT  - PRIMARY CARE
COIS- Competing interests: None declared.
EDAT- 2023/02/25 06:00
MHDA- 2023/03/03 06:00
PMCR- 2023/02/24
CRDT- 2023/02/24 21:49
PHST- 2023/02/24 21:49 [entrez]
PHST- 2023/02/25 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2023/02/24 00:00 [pmc-release]
AID - bmjopen-2022-065230 [pii]
AID - 10.1136/bmjopen-2022-065230 [doi]
PST - epublish
SO  - BMJ Open. 2023 Feb 24;13(2):e065230. doi: 10.1136/bmjopen-2022-065230.