Other characteristics , including specialist versus generalist provision , did not appreciably impact programme effectiveness .
Conclusions Shorter secondary prevention programmes , those based in general practice , and those staffed by generalists are at least as effective in reducing all cause mortality in patients with coronary heart disease as longer programmes , hospital-based programmes , and programmes staffed by specialists
Background The aim of this study was to determine which programme characteristics influence the effectiveness of secondary prevention programmes for Coronary Heart Disease .
Long-Term Effects on Cholesterol Levels and the Utilization of Lipid-Lowering Drugs of a Hospital-Based Programme for Secondary Prevention of Coronary Artery Disease
Background The study was design ed to determine whether a 1-year hospital-based secondary prevention programme would have any long-term effects on serum lipid levels and the use of lipid-lowering drugs in patients with coronary artery disease 4 years after referral to primary care facilities for follow-up . Design / methods After acute myocardial infa rct ion or coronary bypass surgery , 241 consecutive patients were r and omly assigned to conventional care ( CC ) by the primary health care facilities or to a 1-year hospital-based secondary prevention programme ( SPP ) with target levels for serum cholesterol ( < 5.2 mmol/l ) and triglycerides ( < 1.5 mmol/l ) . After 1 year all patients were referred to the primary care sector for a further 4-year follow-up . Results At the 1-year follow-up there was a significant decrease in serum cholesterol , LDL-cholesterol and triglyceride levels in the SPP group but no change in the CC group , and lipid-lowering drugs were used more frequently in the SPP group . These changes were maintained after 5 years . The proportion of patients achieving target serum cholesterol and triglyceride levels were larger in the SPP group . Conclusions Initiatives regarding cholesterol lowering and drug treatment taken by specialists within a structured hospital-based SPP have long-term impact . Accordingly , drug treatment should be initiated and adjusted to adequate doses before patients are referred to primary care for follow-up
Other characteristics , including specialist versus generalist provision , did not appreciably impact programme effectiveness .
Conclusions Shorter secondary prevention programmes , those based in general practice , and those staffed by generalists are at least as effective in reducing all cause mortality in patients with coronary heart disease as longer programmes , hospital-based programmes , and programmes staffed by specialists
Background The aim of this study was to determine which programme characteristics influence the effectiveness of secondary prevention programmes for Coronary Heart Disease .