Secondary prevention in coronary heart disease : a randomised trial of nurse led clinics in primary care.
To evaluate whether nurse run clinics in general practice improve secondary prevention in patients with coronary heart disease.
Design-Randomised controlled trial
Setting-A random sample of 19 general practices in northeast Scotland.
Patients-1173 patients (685 men and 488 women) under 80 years with working diagnoses of coronary heart disease, but without terminal illness or dementia and not housebound.
Intervention-Nurse run clinics promoted medical and lifestyle aspects of secondary prevention and offered regular follow up.
Main outcome measures-Components of secondary prevention assessed at baseline and one year were :
aspirin use ;
blood pressure management ;
lipid management ;
physical activity ;
dietary fat ;
and smoking status.
A cumulative score was generated by counting the number of appropriate components of secondary prevention for each patient.
There were significant improvements in aspirin management (odds ratio 3.22,95% confidence interval 2.15 to 4.80), blood pressure management (5.32,3.01 to 9.41), lipid management (3.19,2.39 to 4.26), physical activity (1.67,1.23 to 2.26) and diet (1.47,1.10 to 1.96).
There was no effect on smoking cessation (0.78,0.47 to 1.28).
Of six possible components of secondary prevention, the baseline mean was 3.27.
The adjusted mean improvement attributable to intervention was 0.55 of a component (0.44 to 0.67).
Improvement was found regardless of practice baseline performance. (...)
Mots-clés Pascal : Cardiopathie coronaire, Prévention, Homme, Infirmier, Ambulatoire, Facteur risque, Ecosse, Grande Bretagne, Royaume Uni, Europe, Exploration, Observance médicamenteuse, Exercice physique, Régime alimentaire, Tabagisme, Traitement, Surveillance, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Coronary heart disease, Prevention, Human, Nurse, Ambulatory, Risk factor, Scotland, Great Britain, United Kingdom, Europe, Exploration, Drug compliance, Physical exercise, Diet, Tobacco smoking, Treatment, Surveillance, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0006820
Code Inist : 002B12A03. Création : 31/05/1999.