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Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial.
- Source :
-
European Journal of Cardiovascular Nursing . Jun2019, Vol. 18 Issue 5, p366-374. 9p. - Publication Year :
- 2019
-
Abstract
- Background and aims: Lack of achievement of secondary prevention objectives in patients with ischaemic heart disease remains an unmet need in this patient population. We aimed at evaluating the six-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an ischaemic heart disease event. Methods: Randomized controlled trial, in which a nurse-led intervention including periodic follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, if appropriate, was compared with standard of care alone in terms of serum lipid-level control at six months after discharge. Results: The nurse-led intervention was associated with an improved management of low-density lipoprotein (LDL) cholesterol levels compared with standard of care alone: LDL cholesterol levels ⩽100 mg/dL were achieved in 97% participants in the intervention arm as compared with 67% in the usual care arm (p value <0.001), the LDL cholesterol ⩽70 mg/dL target recommended by the 2016 European Society of Cardiology guidelines was achieved in 62% vs. 37% participants (p value 0.047) and the LDL cholesterol reduction of ⩾50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% of participants in the intervention arm as compared with 2.6% in the usual care arm (p value 0.007). The intervention was also associated with improved blood pressure control among individuals with hypertension. Conclusions: Our findings highlight the opportunity that nurse-led, intensive, post-discharge follow-up plans may represent for achieving LDL cholesterol guideline-recommended management objectives in patients with ischaemic heart disease. These findings should be replicated in larger cohorts. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CORONARY heart disease prevention
*STATINS (Cardiovascular agents)
*HYPERLIPIDEMIA
*HYPERTENSION
*CARDIOVASCULAR diseases risk factors
*CHI-squared test
*FISHER exact test
*PATIENT aftercare
*LIPIDS
*LOW density lipoproteins
*PATIENT education
*RESEARCH funding
*STATISTICAL sampling
*PILOT projects
*RANDOMIZED controlled trials
*PATIENT discharge instructions
*TREATMENT effectiveness
*DATA analysis software
*NURSING interventions
*PREVENTION
DISEASE relapse prevention
Subjects
Details
- Language :
- English
- ISSN :
- 14745151
- Volume :
- 18
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- European Journal of Cardiovascular Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 136876643
- Full Text :
- https://doi.org/10.1177/1474515119831511