Nurse-led and Interdisciplinary Secondary Cardiovascular Prevention Programmes: Spanish Cohort of the EUROACTION Project

Abstract

Background: Cardiovascular prevention and rehabilitation programmes (CVPRP) are a preventive tool, which can reverse unhealthy behaviours and improve risk factor management. They have been successfully implemented in a variety of settings in patients with coronary heart disease (CHD). Objective: To evaluate an interdisciplinary and nurse-led cardiovascular prevention and rehabilitation programme in patients with coronary heart disease. Method: Six pairs of hospitals were randomised between intervention (INT) and usual care (UC) patients. The interdisciplinary team in the intervention hospital carried out a 16-week CVPRP to reach European risk factor goals. The trial is registered as ISRCTN 71715857. Results: The proportion of patients achieving European cardiovascular recommendations in Spain increased in the intervention hospital, mainly regarding fruit and vegetable consumption (INT 98% vs UC 53%, p<0.001), oily fish consumption (INT 42% vs UC 19.5%, p<0.001), self-reported physical activity (INT 31% vs UC 12.4%, p=0.04), blood pressure (INT 69% vs UC 47.1%) p< 0.05) and LDL concentrations (INT 86.1% vs UC 67.6%, p=0.04). Conclusion: The EUROACTION nurse-led model of CVPR programme has shown that therapeutic goals in cardiovascular disease prevention are affordable and sustainable in everyday clinical practice. EUROACTION model adapted in Spain has produced a healthier lifestyle. Trial registration No. ISRCTN 71715857.

Nurse-led intervention in the management of patients with cardiovascular diseases: a brief literature review

“…To support this statement, the EUROACTION Project which was a nurse-led model of cardiovascular prevention and rehabilitation programmes, and which was adapted in Spain has produced a healthier lifestyle. This model has achieved affordable and sustainable therapeutic goals in cardiovascular disease prevention in everyday clinical practice [ 32 ]. In another study based on the intervention of nurses, a significant number (31.5%) of patients with angina showed that they made changes to their diet, and a significant number of patients (23.3%) increased their daily physical exercises, more precisely walking [ 11 ].…”

The quality of long‐term counselling for percutaneous coronary intervention patients: A cross‐sectional study

“…They share not only PCI patient's lifestyle but also the majority of the coronary risk factors. Therefore, social support needs to be promoted at the household level (Buigues et al, 2022 ; Visseren et al, 2021 ). Especially family involvement is essential for adhering to lifestyle recommendations (De Bacquer et al, 2022 ).…”

“…They share not only PCI patient's lifestyle but also the majority of the coronary risk factors. Therefore, social support needs to be promoted at the household level (Buigues et al, 2022;Visseren et al, 2021).…”

“…In the recent survey, 42% of patients did not achieve the recommended blood pressure target, 46% of patients with known diabetes still presented with an HbA1c value of >7.0% (53 mmol/mol), while the recommended target for low‐density lipoprotein cholesterol of <1.8 mmol/L was reached in 29% of patients only (Kotseva et al, 2019 ). Although there is compelling evidence for nurse‐coordinated patient counselling following PCI treatment, a large majority of the patients fail to achieve lifestyle changes and do not reach the guideline standards for secondary prevention (Buigues et al, 2022 ; De Bacquer et al, 2022 ). This indicates the need for assessing the quality of counselling in long term for patients with coronary heart disease and interventions to ensure long‐lasting results (Buigues et al, 2022 ; Chiang et al, 2018 ).…”

“…Although there is compelling evidence for nurse‐coordinated patient counselling following PCI treatment, a large majority of the patients fail to achieve lifestyle changes and do not reach the guideline standards for secondary prevention (Buigues et al, 2022 ; De Bacquer et al, 2022 ). This indicates the need for assessing the quality of counselling in long term for patients with coronary heart disease and interventions to ensure long‐lasting results (Buigues et al, 2022 ; Chiang et al, 2018 ). This study examines PCI patients' perceptions of counselling quality, with the quality of counselling described based on the content, implementation and benefits of counselling, along with the available resources for counselling (Mäkelä et al, 2022 ).…”