Health Goal Attainment and Satisfaction in Patients at Cardiovascular Risk. Findings of DECADE study

Abstract Background Cardiovascular diseases are the leading cause of death worldwide. Health goals can help with behavioural changes. Self-assessment of goal attainment using Goal Attainment Scaling (GAS) offers a method for assessing individual goal attainment and satisfaction. Objective/question Analysis examined the frequency, attainment and satisfaction with self-set health goals in patients with at least one lifestyle-related cardiovascular risk factor within the DECADE intervention study. Materials and methods Cluster-randomised controlled DECADE study included four study arms. Intervention groups received patient materials (IG1) and/or additional structured patient-centred consultations with their general practitioner (IG2 and IG3). The patients (n = 712) completed questionnaires at the start of the study (t0), after 6 months (t1) and after 12 months (t2). At t1 and t2, health goals, goal attainment (6-point Likert scale) and satisfaction (5-point Likert scale) were assessed. Analysis was performed using medians and group differences using Kruskal-Wallis tests. Results At t1 and t2, participants reported a median of six health goals. The most frequently reported goals were healthy eating, regular physical activity and weight loss. Although patients had largely achieved their goals (Mt1=2.74 [0.33-5.00]; Mt2=2.71 [0.00-5.00]), they were only partially satisfied with the outcomes (Mt1=2.80 [1.00-5.00]; Mt2=2.75 [1.00-5.00]). Patients who received additional consultations (IG2 and IG3) showed significantly higher GAS scores at t2 than those in groups without consultations (CG0 and IG1) (M = 2.80; M = 2.86 vs. M = 2.50; M = 2.58, p = 0.004). No gender- or income-specific differences were found. Discussion The most frequently mentioned goals were lifestyle-oriented. The DECADE intervention with structured patient-centred consultations supports patients in attaining their health goals. Regular consultations appear to be particularly effective. Key messages • Structured, patient-centred consultations are beneficial for achieving health goals. • Even when goals are largely achieved, patient satisfaction may remain low - expectation management is key.