VET-COACH
Trial question
What is the effect of a peer health coaching program among veterans with cardiovascular risks?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
13.0% female
87.0% male
N = 264
264 patients (35 female, 229 male).
Inclusion criteria: veterans with a diagnosis of hypertension with at least 1 BP reading ≥ 150/90 mmHg in the past year, and 1 other cardiovascular risk factor.
Key exclusion criteria: hospitalization in the past 3 months for cardiovascular-related conditions, severe illness that precludes lifestyle program; nursing home resident; severe cognitive impairment; receipt of home-based primary care.
Interventions
N=134 peer health coaching program (home visits from a peer health coach targeting disease self-management).
N=130 usual care (continue to receive regular, usual primary care).
Primary outcome
Reduction in systolic blood pressure at 12 months
3.32 mmHg
0.4 mmHg
3.3 mmHg
2.5 mmHg
1.7 mmHg
0.8 mmHg
0.0 mmHg
Peer health coaching
program
Usual
care
No significant
difference ↔
No significant difference in reduction in SBP at 12 months (3.32 mmHg vs. 0.4 mmHg; AD 2.05 mmHg, 95% CI -2.55 to 7).
Secondary outcomes
Significantly greater improvement in mental health-related QoL score (2.19 points vs. -1.01 points; AD 3.64 points, 95% CI 0.66 to 6.63).
No significant difference in improvement in physical health-related QoL score (1.02 points vs. 0.72 points; AD 0.51 points, 95% CI -1.76 to 2.77).
No significant difference in reduction in Framingham Risk Score (0.01 points vs. 0.01 points; AD 0.01 points, 95% CI -0.01 to 0.03).
Conclusion
In veterans with a diagnosis of hypertension with at least 1 BP reading ≥ 150/90 mmHg in the past year, and 1 other cardiovascular risk factor, peer health coaching program was not superior to usual care with respect to reduction in SBP at 12 months.
Reference
Karin M Nelson, Leslie Taylor, Jennifer L Williams et al. Effect of a Peer Health Coaching Intervention on Clinical Outcomes Among US Veterans With Cardiovascular Risks: The Vet-COACH Randomized Clinical Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2317046.
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