Influence of coronary nursing management follow up on lifestyle after acute myocardial infarction.

Abstract

Objective-To examine the ability of a secondary prevention programme to improve the lifestyle in myocardial infarction patients aged 50-70 years. Design-Habitual physical activity, food habits, and smoking habits were assessed from questionnaires at admission to hospital and at the one year follow up. Initially, all patients were invited to join an exercise programme and were informed about cardiovascular risk factors. Four weeks after discharge from the hospital, 87 patients were randomised to follow up at the coronary prevention unit by a special trained nurse (the intervention group), and 81 to follow up by their general practitioners (the usual care group). After randomisation, the intervention group was educated about the effects of smoking cessation, dietary management, and regular physical activity. The intervention group also participated in a physical training programme two to three times weekly for 10-12 weeks. Main results-89% of the patients referred to the intervention group improved their food habits compared with 62% of the patients referred to the usual care group (P = 0.008). Furthermore, 50% of the smokers referred to the intervention group stopped smoking compared to 29% in the usual care group (P = 0.09).Changes in physical activity did not differ between the groups.Conclusions-This secondary prevention programme based on a nurse rehabilitator was successful in improving food habits in patients with acute myocardial infarction. Initiating the smoking cessation programme during the hospital stay followed by repeated counselling during follow up might have improved the results. The exercise programme had no advantage in supporting physical activity compared to usual care.

The efficacy of smoking cessation therapies in cardiac patients: A meta-analysis of randomized controlled trials

“…In most RCTs, the therapy consisted of a major behavioural intervention that included stop-smoking advice or counselling. Most of the counselling administered was individual (one-on-one with a therapist or nurse); two studies used both individual and group therapy (25,26). One study also offered NRT to patients who relapsed (19).…”

“…Studies also differed in the amount of clinical follow-up data collected, ranging from six months to five years of follow-up. Only one RCT reported point prevalence at six months (1), and nine of 11 RCTs reported continuous abstinence at 12 months (1,(18)(19)(20)(21)23,(25)(26)(27) (Table 2). Smoking abstinence was biochemically validated in eight of 11 behavioural RCTs (1,(18)(19)(20)(21)(22)(23)(24).…”

Nursing intervention and smoking cessation: Meta-analysis update

“…One trial 20 had two parts with randomization at each stage, so it is treated here as two separate studies, making a total of 35 studies. Fifteen trials [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] intervened with hospitalized patients; one 36 recruited hospitalized patients, but the intervention was given after discharge. Fifteen studies 20,37-50 recruited patients from primary care or outpatient clinics.…”

Improved Exercise Tolerance and Quality of Life With Cardiac Rehabilitation of Older Patients After Myocardial Infarction

“…5 Such a limited generalizability of results of CR trials to the older population identifies an important research gap. 1 Only limited age-specific data are available from trials with an average patient age Ͻ75 years [5][6][7][8][9][10][11][12][13] and from observational studies of post-MI CR with small numbers of patients Ͼ75 years of age. 14 -16 In particular, whether CR improves exercise tolerance similarly in patients younger and older than 75 years remains uncertain.…”