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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

Ögmundsdottir Michelsen, Halldora LU ; Nilsson, Marie; Scherstén, Fredrik LU ; Sjölin, Ingela LU ; Schiopu, Alexandru LU and Leosdottir, Margret LU (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
organization
publishing date
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
publisher
BioMed Central
external identifiers
  • scopus:85051701247
ISSN
1471-2261
DOI
10.1186/s12872-018-0907-0
language
English
LU publication?
yes
id
f0cc872a-c6ef-45be-b29a-73acd473a37a
date added to LUP
2018-09-10 09:29:40
date last changed
2019-02-20 11:26:05
@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&lt;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>},
  articleno    = {167},
  author       = {Ögmundsdottir Michelsen, Halldora and Nilsson, Marie and Scherstén, Fredrik and Sjölin, Ingela and Schiopu, Alexandru and Leosdottir, Margret},
  issn         = {1471-2261},
  keyword      = {Acute myocardial infarction,Cardiac rehabilitation,Cardiovascular risk factors,Nurse-led care,Secondary prevention},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {BioMed Central},
  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},
  volume       = {18},
  year         = {2018},
}