2.2.2. Outcomes and Sources Effectiveness Study
SECONDARY
The primary outcomes were lifestyle behaviour—and cardiovascular risk factors (described below) in the period 3–6 months (short term) and 12–24 (longer term) months after baseline. The secondary outcome was the number of cardiovascular-risk-management (CVRM)-related primary practice consultations in the past 6 months and the difference in weight, physical activity, dietary quality and alcohol usage between those who set a goal at baseline for these outcomes and those who did not. Outcomes were measured at baseline, 3, 6, 12 and 24 months from digital or hard-copy questionnaires or continuously between baseline and 27 months from the EHR. An overview of all measurements is displayed in Outcomes derived from questionnaires were total minutes of physical activity per week (Short Questionnaire to Assess Health-enhancing physical activity), dietary quality (total score from the Dutch Healthy Diet (DHD) index; higher scores indicate higher diet quality) and smoking (never/previous/current smoker). Patient-reported smoking cessation was defined as being a smoker at baseline and reported ‘no smoking during the last 7 days’ (3–6 months) or ‘no smoking during the last 6 months’ (12–24 months) at follow-up measurements [Outcomes derived from the EHR were systolic blood pressure (SBP) (mmHg), LDL-cholesterol (mmol/L), HDL-cholesterol (mmol/L). EHR measurements were selected as the nearest to the exact date of baseline, baseline plus 3, 6, 12 and 24 months in a six-week range around baseline, baseline plus 3 and 6 months and a two-month range around baseline plus 1 and 24 months. CVRM-related visits during the 6 months prior to baseline, baseline–6 months, 6–12 months, 12–18 months and 18–24 months, respectively, were derived from the EHR, reasoning that a record of an anamnestic (e.g., alcohol intake), SBP measurement or laboratory test indicated either a live or telephone visit to the primary practice.Weight and alcohol consumption were primarily derived from questionnaires (patient-reported weight (kg) and mean number of units of alcohol per day, calculated from the DHD-index). When patient-reported data were missing, the data were filled in with weight (kg) registrations in the EHR registered with ‘average alcohol use’ in the EHR.For the EHR-derived data, all registered measurements between 3–6 months and 12–24 months were included in the effect analysis.