Abbonarsi

Clinical trial of an educational intervention to achieve recommended cholesterol levels in patients with coronary artery disease - 26/08/11

Doi : 10.1016/j.ahj.2003.06.003 
Judith H Lichtman, PhD a, b, Joan Amatruda, RN c, Shlomit Yaari, MS a, Susan Cheng, BA a, Grace L Smith, MPH a, Jennifer A Mattera, MPH a, Sarah A Roumanis, RN a, Yun Wang, MS a, Martha J Radford, MD c, d, Harlan M Krumholz, MD a, c, e,
a Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn, USA 
b Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn, USA 
c Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Conn, USA 
d Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Conn, USA 
e Section of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn, USA 

*Reprint requests: Harlan M. Krumholz, MD, Yale University School of Medicine, PO Box 208025, New Haven, CT 06520-8025, USA.

Abstract

Background

Despite national efforts to improve cholesterol management for patients with coronary artery disease, many patients are not reaching recommended cholesterol target levels. We sought to determine whether a nurse-based educational intervention, designed to educate patients with confirmed coronary artery disease about personal low-density lipoprotein (LDL) cholesterol target levels and encourage partnership with physicians, could increase adherence with National Cholesterol Education Program target levels (LDL cholesterol level ≤100 mg/dL).

Methods

Patients hospitalized with confirmed coronary artery disease were randomized to undergo a nurse-based educational intervention (375 patients) or usual care (381 patients) for a 12-month period after hospitalization. The primary outcome was the proportion of patients at the LDL cholesterol target level 1 year after hospitalization. The secondary outcome was the proportion of patients with accurate knowledge of LDL cholesterol target levels.

Results

The groups were similar at baseline in demographic and clinical characteristics, percent at LDL cholesterol target level (43.9% and 41.1%, respectively), and percent with knowledge of LDL cholesterol target levels (both 5%). The proportion of patients at LDL cholesterol target levels at 1 year did not differ between the intervention (70.2%) and usual care group (67.4%, P = .46). At the conclusion of the trial, patient knowledge about LDL cholesterol target level was higher for the intervention group than the usual care group (19.6% and 6.7%, respectively, P = .001), but this was not associated with improved cholesterol management.

Conclusions

Our nurse-based educational intervention did not result in a significant increase in the proportion of patients who reached target LDL cholesterol levels 1 year after hospitalization. Although the intervention improved patient knowledge of LDL cholesterol target levels, overall rates of LDL cholesterol knowledge remained low, and it was not associated with improved cholesterol management.

Il testo completo di questo articolo è disponibile in PDF.

Mappa


 Supported by a grant from Pfizer. Dr Lichtman is a Goddess Fund Career Development Scholar.


© 2004  Mosby, Inc. Tutti i diritti riservati.
Aggiungere alla mia biblioteca Togliere dalla mia biblioteca Stampare
Esportazione

    Citazioni Export

  • File

  • Contenuto

Vol 147 - N° 3

P. 522-528 - Marzo 2004 Ritorno al numero
Articolo precedente Articolo precedente
  • Influence of endothelial nitric oxide synthase gene polymorphisms (G894T, 4a4b, T-786C) and hyperhomocysteinemia on the predisposition to acute coronary syndromes
  • Cinzia Fatini, Francesco Sofi, Elena Sticchi, Francesca Gensini, Anna Maria Gori, Sandra Fedi, Ilaria Lapini, Carlo Rostagno, Marco Comeglio, Daria Brogi, Gianfranco Gensini, Rosanna Abbate
| Articolo seguente Articolo seguente
  • Lifestyle determinants of high-density lipoprotein cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study
  • R.Curtis Ellison, Yuqing Zhang, Muhammad Mustafa Qureshi, Sarah Knox, Donna K Arnett, Michael A Province, Investigators of the NHLBI Family Heart Study

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Già abbonato a @@106933@@ rivista ?

Il mio account


Dichiarazione CNIL

EM-CONSULTE.COM è registrato presso la CNIL, dichiarazione n. 1286925.

Ai sensi della legge n. 78-17 del 6 gennaio 1978 sull'informatica, sui file e sulle libertà, Lei puo' esercitare i diritti di opposizione (art.26 della legge), di accesso (art.34 a 38 Legge), e di rettifica (art.36 della legge) per i dati che La riguardano. Lei puo' cosi chiedere che siano rettificati, compeltati, chiariti, aggiornati o cancellati i suoi dati personali inesati, incompleti, equivoci, obsoleti o la cui raccolta o di uso o di conservazione sono vietati.
Le informazioni relative ai visitatori del nostro sito, compresa la loro identità, sono confidenziali.
Il responsabile del sito si impegna sull'onore a rispettare le condizioni legali di confidenzialità applicabili in Francia e a non divulgare tali informazioni a terzi.


Tutto il contenuto di questo sito: Copyright © 2024 Elsevier, i suoi licenziatari e contributori. Tutti i diritti sono riservati. Inclusi diritti per estrazione di testo e di dati, addestramento dell’intelligenza artificiale, e tecnologie simili. Per tutto il contenuto ‘open access’ sono applicati i termini della licenza Creative Commons.