The effect of post-discharge educational intervention on patients in achieving objectives in modifiable risk factors six months after discharge following an episode of acute coronary syndrome, (CAM-2 Project): a randomized controlled trial

Health and Quality of Life Outcomes

Research

Javier Muñiz¹  Alfonso Castro-Beiras²  María I Santiago-Pérez³  Iñaki Lekuona-Goya⁴  José M Cruz-Fernández⁵  Juan J Gómez-Doblas⁶  Eduardo de Teresa-Galván ß⁶  Nekane Murga-Eizagaetxebarría⁷ 

[1] Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña, Spain;Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña, Spain;Servicio de Cardiología, Servicio Galego de Saúde, Complejo Hospitalario Universitario de A Coruña, La Coruña, Spain;S.L., ODDS, La Coruña, Spain;Servicio de Cardiología, Hospital Galdakao, Vizcaya, Spain;Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla, Spain;Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Malaga, Spain;Servicio de Cardiología, Hospital de Basurto, Vizcaya, Spain;

关键词: Acute Coronary Syndrome;    Secondary Prevention;    Coronary Heart Disease Patient;    Initial Body Mass Index;    Spanish Hospital;   

DOI  :  10.1186/1477-7525-8-137

 received in 2010-08-26, accepted in 2010-11-22,  发布年份 2010

来源: Springer

【 摘 要 】

ObjectivesWe investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached, improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome.BackgroundThere is room to improve mid-term adherence to clinical guidelines' recommendations in coronary heart disease secondary prevention, specially non-pharmacological ones, often neglected.MethodsIn CAM-2, patients discharged after an acute coronary syndrome were randomly assigned to the intervention or the usual care group. The primary outcome was reaching therapeutic objectives in various secondary prevention variables: smoking, obesity, blood lipids, blood pressure control, exercise and taking of medication.Results1757 patients were recruited in 64 hospitals and 1510 (762 in the intervention and 748 in the control group) attended the six-months follow-up visit. After adjustment for potentially important variables, there were, between the intervention and control group, differences in the mean reduction of body mass index (0.5 vs. 0.2; p < 0.001) and waist circumference (1.6 cm vs. 0.6 cm; p = 0.05), proportion of patients who exercise regularly and those with total cholesterol below 175 mg/dl (64.7% vs. 56.5%; p = 0.001). The reported intake of medications was high in both groups for all the drugs considered with no differences except for statins (98.1% vs. 95.9%; p = 0.029).ConclusionsAt least in the short term, lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention.

【 授权许可】

CC BY   
© Muñiz et al; licensee BioMed Central Ltd. 2010