There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .
A randomized, controlled trial for risk factor reduction in patients with symptomatic vascular disease: the multidisciplinary Vascular Prevention by Nurses Study (VENUS)
Background Patients with manifest vascular disease are at high risk of a new vascular event or death . Modification of classical risk factors is often not successful . We determined whether the extra care of a nurse practitioner could be beneficial to the cardiovascular risk profile of high-risk patients . Design We conducted a r and omized , controlled trial based on the Zelen design . Methods Two hundred and thirty-six patients with manifestations of a vascular disease and who had two or more modifiable vascular risk factors were pre-r and omized to receive treatment by a nurse practitioner plus usual care or usual care alone . After 1 year , risk factors were remeasured . The primary endpoint was achievement of treatment goals for blood pressure , lipid , glucose and homocysteine levels , body mass index , and smoking . Results Of the pre-r and omized patients , 95 of 119 ( 80 % ) in the intervention group and 80 of 117 ( 68 % ) in the control group participated in the study . After a mean follow-up of 14 months , the patients in the intervention group achieved significantly more treatment goals than did the patients in the control group ( systolic blood pressure 63 versus 37 % , total cholesterol 79 versus 61 % , low density lipoprotein-cholesterol 88 versus 67 % , and body mass index 38 versus 24 % ) . Medication use was increased in both groups and no differences were found in patients ' quality of life ( SF-36 ) at follow-up . Conclusion Treatment delivered by nurse practitioners , in addition to a vascular risk factor screening and prevention program , result ed in a better management of vascular risk factors than usual care alone in vascular patients after 1-year follow-up
There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .