CRISP
Research type
Research Study
Full title
Cardiovascular Risk reduction In the NHS abdominal aortic aneurysm (AAA) Screening Programme: a co-developed cardiovascular prevention intervention (the CRISP study)
IRAS ID
273793
Contact name
Athanasios Saratzis
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
3 years, 5 months, 30 days
Research summary
"Abdominal Aortic Aneurysm" or AAA is an abnormal swelling of the aorta, the biggest blood-vessel in the body. It usually occurs in men aged over 65. An AAA can occasionally burst, leading to life-threatening bleeding. It can, however, be easily detected using a simple ultrasound-scan.
“AAA screening programmes” are now available across the UK. These programmes invite men at the age of 65 to have an ultrasound scan to check for AAA.
We already know that if someone has even a small AAA, they are far more likely to develop heart attacks and strokes (known as “cardiovascular events”) compared to people without AAA. Despite this, individuals with AAAs do not receive adequate help and support to prevent cardiovascular events. This is an important missed opportunity. The existing AAA screening programmes can be used to improve the treatment of people with small AAAs by offering them medication and help to prevent cardiovascular events. Therefore, the aim of this research is to develop and then test a health intervention which will improve the cardiovascular health of individuals with small AAAs.
Design, Methods, Patient & Public Involvement
This research will consist of two stages:
1) In the first stage, patients with AAA, their relatives, and experts in this area will work together to develop the intervention aimed to improved cardiovascular health in those with AAA. The first aim will be to identify the barriers that prevent good cardiovascular care in people with AAA. Then, the patients and experts will discuss how these can be overcome. The intervention will eventually be designed using that information.
2) In the second stage (future study), the intervention will be tested in the Leicestershire AAA screening unit to assess how many men with AAA will take it up.Lay summary of study results: Cardiovascular Risk reduction In the NHS abdominal aortic aneurysm (AAA) Screening Programme: a co-developed cardiovascular prevention intervention (the CRISP study)
Plain English Summary
Background: Abdominal aortic aneurysm (AAA) screening and surveillance is now implemented in many healthcare systems. Those in AAA-surveillance are at elevated risk of cardiovascular events, which is not currently systematically addressed in the UK. We developed an intervention, called CRISP, using intervention-mapping with input from patients and stakeholders across the United Kingdom (UK), to reduce cardiovascular risk in AAA-surveillance.
Aim/research question: To test the feasibility study in routine clinical care.
Methods: The CRISP intervention, which consists of a nurse-led cardiovascular risk assessment and subsequent lifestyle change support using a printed self-care support workbook and low-intensity nurse support, was delivered across the Leicester, Leicestershire and Rutland AAA screening and surveillance programme. Those who consented to take part were followed-up with cardiovascular assessments. Fidelity of intervention-delivery was assessed quantitatively and qualitatively.
Findings: A total of 40 men consented to take part over four months and were followed-up for a minimum six months. A sub-group of patients (n=25) and Health Care Professionals (HCPs) (n=9) took part in interviews to qualitatively assess intervention delivery. The median number of risk-factors that patients chose to focus on was two (range 0 to 4), with physical activity (n=17) being the most popular. Participants who had a ‘red light’ risk factor for stress, low mood, smoking or alcohol intake were offered a referral to appropriate services. Two were offered referral to mental health services and took it up, three declined referrals to smoking or alcohol support services. The fidelity of intervention-delivery was generally low. In qualitative interviews, the intervention was liked and viewed as beneficial by both patients and HCPs. Based on qualitative interviews and our observations, the low fidelity of intervention-delivery was due to intervention-training not being sufficiently detailed.
Dissemination: Findings have been submitted to journals, sent to patients, and NHS societies.
Impact: The CRISP intervention can be delivered in routine AAA-surveillance, but the fidelity of delivery in its current format is low. The intervention and its training course need to be refined accordingly and further feasibility-tested before wider evaluation. A further randomised study is in the process of being developed.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
19/EM/0366
Date of REC Opinion
20 Jan 2020
REC opinion
Further Information Favourable Opinion