Details

Autor(en) / Beteiligte

• Allison, Thomas G
• Farkouh, Michael E
• Smars, Peter A
• Evans, Roger W
• Squires, Ray W
• Gabriel, Sherine E
• Kopecky, Stephen L
• Gibbons, Raymond J
• Reeder, Guy S

Titel

Management of coronary risk factors by registered nurses versus usual care in patients with unstable angina pectoris (a chest pain evaluation in the emergency room [CHEER] substudy)

Ist Teil von

• The American journal of cardiology, 2000-07, Vol.86 (2), p.133-138

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2000

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• This study examined whether nurses could manage coronary risk factors in patients with unstable angina more effectively than physicians practicing usual care. Three hundred twenty-six patients were randomized in the emergency room to a 6-month program of risk factor management by a registered nurse versus participation in usual care. The nurse intervention consisted of a 30-minute counseling visit at 6 to 10 days after the chest pain episode and a second 30-minute session 1 month later. Multiple risk factors were assessed and addressed: smoking, blood lipids, blood pressure, blood glucose, physical inactivity, weight, psychological stress, and social isolation. Compared with usual care, nurse intervention patients significantly reduced both triglycerides (−29 ± 8 vs 5 ± 6 mg/dl; p <0.0004) and weight (−0.9 ± 3.3 vs +0.1 ± 2.1 kg; p = 0.0071), and had corresponding improvements in self-reported diet compliance and exercise (+34 ± 106 vs +9 ± 98 minutes, p = 0.0491). No significant differences between groups were observed in terms of 6-month changes in total, high-density lipoprotein, or low-density lipoprotein cholesterol, blood pressure, fasting blood glucose, percent body fat or waist-hip ratio, or psychological distress scores. The 6-month rate of recurrent events (cardiac death, out-of-hospital cardiac arrest, myocardial infarction) and/or revascularizations (coronary artery bypass surgery or coronary angioplasty) was lower in the nurse intervention group (1% vs 9%; p = 0.002). We conclude that a nurse-delivered risk factor intervention program for patients with chest pain is feasible and more effective than usual care in terms of fostering lifestyle changes that may lower coronary risk.