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Witt, Sabine; Leidl, Reiner ORCID logoORCID: https://orcid.org/0000-0002-7115-7510; Becker, Christian; Holle, Rolf; Block, Michael; Brachmann, Johannes; Silber, Sigmund and Stollenwerk, Björn (2014): The Effectiveness of the Cardiovascular Disease Prevention Programme 'KardioPro' Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data.
In: PLOS ONE 9(12), e114720 [PDF, 554kB]


Background: Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund ('Siemens-Betriebskrankenkasse', SBK) initiated the prevention programme 'KardioPro' including primary (risk factor reduction) and secondary (screening) prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of 'KardioPro' as it is implemented in the real world. Methods: The study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint 'all-cause mortality, acute myocardial infarction (MI) and ischemic stroke (1)', 'all-cause mortality (2)' and 'non-fatal acute MI and ischemic stroke (3)'. Results: A total of 26, 202 insurants were included, 13, 101 participants and 13, 101 control subjects. 'KardioPro' enrolment was associated with risk reductions of 23.5% (95% confidence interval (CI) 13.0-32.7%) (1),41.7% (95% CI 30.2-51.2%) (2) and 3.5% (hazard ratio 0.965, 95% CI 0.811-1.148) (3). This corresponds to an absolute risk reduction of 0.29% (1),0.31% (2) and 0.03% (3) per year. Conclusion: The prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

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