SPHERE Study: Secondary Prevention of Heart Disease in General Practice, 2003-2008

The SPHERE Study: Secondary Prevention of Heart Disease in General Practice, was the largest ever non-pharmaceutical trial in Irish general practice. The aim of the study was to design, implement and test the effectiveness of a complex intervention to improve the process of care and objective clinical outcomes for patients with established coronary heart disease in primary care.<br> <br> The SPHERE intervention was designed in consultation with patients and practitioners. Based on principles of patient-centred care, brief motivational interviewing and best practice in medication prescribing, it has the following components: <br> <br> 1. Practitioners attend two 90-minute training sessions, the first on facilitating lifestyle behaviour change, and the second on optimal medication prescribing for secondary prevention<br> 2. Patients visit the practice for review every four months<br> 3. Ongoing support is provided to practitioners by regional SPHERE research nurses<br> 4. A study newsletter is circulated to intervention practices every four months<br> <br> Patients with established coronary heart disease were selected from 48 general practices taking part in the study in the East, North and West Ireland. Half the practices were randomly chosen to receive the intervention for 18 months, while the other half continued to provide usual care to their patients. Detailed information about patient risk factors and health status was collected at the beginning of the study and again at the end. <br> <br> Further information, including results and publications, can be found on the <a href="http://www.spherestudy.com/index.html" title="the SPHERE study">SPHERE</a> study website.<br> <br> Users should note that the British Medical Journal (BMJ) article in the user guide has been included with the permission of the BMJ. It is covered by a Creative Commons licence, which allows <b>non-commercial</b> use as long as the article is properly cited. To seek permission for commercial re-use, see the BMJ's <a href="http://group.bmj.com/group/rights-licensing/permissions/permission-for-open-access-articles" title="Permission for Open Access articles">Permission for Open Access articles</a> webpage.<br>