Tailored nurse-led cardiac rehabilitation after myocardial infarction results in better risk factor control at one year compared to traditional care : A retrospective observational study
(2018) In BMC Cardiovascular Disorders 18(1).- Abstract
Background: Cardiac rehabilitation improves prognosis after an acute myocardial infarction (AMI), however, the optimal method of implementation is unknown. The aim of the study was to evaluate the effect of individually-tailored, nurse-led cardiac rehabilitation on patient outcomes. Method: This single-centre retrospective observational study included 217 patients (62±9years, 73% men). All patients attended cardiac rehabilitation including at least two follow-up consultations with a nurse. Patients receiving traditional care (n=105) had a routine cardiologist consultation, while for those receiving tailored care (n=112) their need for a cardiologist consultation was individually evaluated by the nurses. Regression analysis was used to... (More)
Background: Cardiac rehabilitation improves prognosis after an acute myocardial infarction (AMI), however, the optimal method of implementation is unknown. The aim of the study was to evaluate the effect of individually-tailored, nurse-led cardiac rehabilitation on patient outcomes. Method: This single-centre retrospective observational study included 217 patients (62±9years, 73% men). All patients attended cardiac rehabilitation including at least two follow-up consultations with a nurse. Patients receiving traditional care (n=105) had a routine cardiologist consultation, while for those receiving tailored care (n=112) their need for a cardiologist consultation was individually evaluated by the nurses. Regression analysis was used to analyse risk factor control and hospital readmissions at one year. Results: Patients in the tailored group achieved better control of total cholesterol (-0.1 vs+0.4 mmol/L change between baseline (time of index event) and 12-14-month follow-up, (p=0.01), LDL cholesterol (-0.1 vs+0.2 mmol/L, p=0.02) and systolic blood pressure (-2.1 vs+4.3 mmHg, p=0.01). Active smokers, at baseline, were more often smoke-free at one-year in the tailored group [OR 0.32 (0.1-1.0), p=0.05]. There was a no significant difference in re-admissions during the first year of follow-up. In the tailored group 60% of the patients had a cardiologist consultation compared to 98% in the traditional group (p<0.001). The number of nurse visits was the same in both groups, while the number of telephone contacts was 38% higher in the tailored group (p=0.02). Conclusion: A tailored, nurse-led cardiac rehabilitation programme can improve risk factor management in post-AMI patients.
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- author
- Ögmundsdottir Michelsen, Halldora LU ; Nilsson, Marie ; Scherstén, Fredrik LU ; Sjölin, Ingela LU ; Schiopu, Alexandru LU and Leosdottir, Margret LU
- organization
- publishing date
- 2018-08-15
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acute myocardial infarction, Cardiac rehabilitation, Cardiovascular risk factors, Nurse-led care, Secondary prevention
- in
- BMC Cardiovascular Disorders
- volume
- 18
- issue
- 1
- article number
- 167
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85051701247
- pmid:30111283
- ISSN
- 1471-2261
- DOI
- 10.1186/s12872-018-0907-0
- project
- Evaluation and improvement of secondary prevention after myocardial infarction
- language
- English
- LU publication?
- yes
- id
- f0cc872a-c6ef-45be-b29a-73acd473a37a
- date added to LUP
- 2018-09-10 09:29:40
- date last changed
- 2024-08-19 22:29:45
@article{f0cc872a-c6ef-45be-b29a-73acd473a37a, abstract = {{<p>Background: Cardiac rehabilitation improves prognosis after an acute myocardial infarction (AMI), however, the optimal method of implementation is unknown. The aim of the study was to evaluate the effect of individually-tailored, nurse-led cardiac rehabilitation on patient outcomes. Method: This single-centre retrospective observational study included 217 patients (62±9years, 73% men). All patients attended cardiac rehabilitation including at least two follow-up consultations with a nurse. Patients receiving traditional care (n=105) had a routine cardiologist consultation, while for those receiving tailored care (n=112) their need for a cardiologist consultation was individually evaluated by the nurses. Regression analysis was used to analyse risk factor control and hospital readmissions at one year. Results: Patients in the tailored group achieved better control of total cholesterol (-0.1 vs+0.4 mmol/L change between baseline (time of index event) and 12-14-month follow-up, (p=0.01), LDL cholesterol (-0.1 vs+0.2 mmol/L, p=0.02) and systolic blood pressure (-2.1 vs+4.3 mmHg, p=0.01). Active smokers, at baseline, were more often smoke-free at one-year in the tailored group [OR 0.32 (0.1-1.0), p=0.05]. There was a no significant difference in re-admissions during the first year of follow-up. In the tailored group 60% of the patients had a cardiologist consultation compared to 98% in the traditional group (p<0.001). The number of nurse visits was the same in both groups, while the number of telephone contacts was 38% higher in the tailored group (p=0.02). Conclusion: A tailored, nurse-led cardiac rehabilitation programme can improve risk factor management in post-AMI patients.</p>}}, author = {{Ögmundsdottir Michelsen, Halldora and Nilsson, Marie and Scherstén, Fredrik and Sjölin, Ingela and Schiopu, Alexandru and Leosdottir, Margret}}, issn = {{1471-2261}}, keywords = {{Acute myocardial infarction; Cardiac rehabilitation; Cardiovascular risk factors; Nurse-led care; Secondary prevention}}, language = {{eng}}, month = {{08}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{BMC Cardiovascular Disorders}}, title = {{Tailored nurse-led cardiac rehabilitation after myocardial infarction results in better risk factor control at one year compared to traditional care : A retrospective observational study}}, url = {{http://dx.doi.org/10.1186/s12872-018-0907-0}}, doi = {{10.1186/s12872-018-0907-0}}, volume = {{18}}, year = {{2018}}, }