First pill hardest to swallow: An evaluation study of cardiovascular nurse-led follow-up phone calls.

INTRODUCTION: Screening for cardiovascular disease (CVD) followed by preventive medication is expected to reduce CVD (2,3,5). However, insufficient medication adherence may affect screening effectiveness (11-12). It remains uncertain which interventions are suitable to support citizens in their decision-making about taking CVD preventive medication. OBJECTIVE: We evaluated if and how three nurse-led telephone follow-up (TFU) calls supported citizens in making informed decisions regarding CVD preventive medication and thereby potentially strengthened their medication adherence. METHODS: Employing a theory-based evaluation design inspired by Dahler-Larsen (39-41), we developed and tested a programme theory describing if and how the TFU calls supported medical decision-making and potentially improved medication adherence. Data were collected via telephone. FINDINGS: We analysed 61 TFU calls collected between May 2017 and April 2019 and found that TFU calls supported participants' reflections on preventive medication. TFU calls supported informed decision-making regarding initiating medication, allowing participants to consider personal preferences and values, including both opting for and abstaining from medication. The content of the TFU calls revolved around four crucial themes: I) understanding the purpose of taking the medicine; II) meaningfulness and joint reflection support the decision; III) relation to healthcare professionals; and IV) taking medication for the first time. CONCLUSION: TFU calls effectively supported citizens' understanding and addressed their needs. Trusted healthcare professionals' recommendations were preferred for decisional support. Initiating CVD preventive medication was particularly challenging for citizens who had not previously taken such medication. We recommend scheduling TFU calls early: the first after one week, the second after one month and the third after six months.

[Atherectomy for peripheral arterial disease]. / Aterektomi for perifer arteriel sygdom ­ en gennemgang af et Cochranereview

Symptomatic peripheral arterial disease is managed according to national and international guidelines and the number of vascular reconstructions performed each year has increased over the past decade mainly due to an increasing frequency of endovascular procedures. Atherectomy as an alternative to the established treatment of symptomatic peripheral arterial disease has recently been analysed in a Cochrane review. In Denmark, atherectomy is not performed and so far the evidence is poor as the method is not an alternative to the established treatment in this country.

[Trampoline accident with anterior knee dislocation caused popliteal artery disruption]. / Knæledsluksation og skade på arteria poplitea efter trampolinspring.

Only a few reports describe the risk of neurovascular damage following knee dislocation while trampolining. A 16 year-old male in a trampoline accident, sustained multi-ligament damage and occlusion of the popliteal artery. The occlusion did not show clinically until 24 hours after the trauma. He underwent vascular surgery (short saphenous bypass). We recommend implementing algorithms, for the management of suspected knee dislocation and possible accompanying neurovascular injuries in all trauma centers.

[Medical treatment of small abdominal aortic aneurysms]. / Medicinsk behandling af små abdominale aortaaneurismer.

Our expectation is that the numbers of diagnosed small abdominal aortic aneurysms (AAA) will increase in the future. Slowing down the progression of AAAs is of great interest as this could prevent cost-intensive and potential lethal operations. Recent studies indicate that modern medical treatment such as prevention for cardiovascular disease has a spin-off benefit by suppressing the expansion rate of AAAs. According to these studies ACE inhibitors, statins and nonsteroidal anti-inflammatory drugs may have effect, macrolides may have some effect while beta-blockers and calcium-channel blockers have no effect.