There were no significant effects of interventions on mean blood pressure or cholesterol levels , prescribing , smoking status or body mass index .
There was some suggestion of a " ceiling effect " whereby interventions have a diminishing beneficial effect once certain levels of risk factor management are reached .
There is weak evidence that regular planned recall of patients for appointments , structured monitoring of risk factors and prescribing , and education for patients can be effective in increasing the proportions of patients within target levels for cholesterol control and blood pressure .
BACKGROUND Ischaemic heart disease ( IHD ) is a major cause of mortality and morbidity and its prevalence is set to increase .
Secondary prevention aims to prevent subsequent acute events in people with established IHD .
While the benefits of individual medical and lifestyle interventions is established , the effectiveness of interventions which seek to improve the way secondary preventive care is delivered in primary care or community setting s is less so .
OBJECTIVES To assess the effectiveness of service organisation interventions , identifying which types and elements of service change are associated with most improvement in clinician and patient adherence to secondary prevention recommendations relating to risk factor levels and monitoring ( blood pressure , cholesterol and lifestyle factors such as diet , exercise , smoking and obesity ) and appropriate prophylactic medication .
Changes in functional health status of older women with heart disease: evaluation of a program based on self-regulation.
OBJECTIVES This study involving 570 women aged 60 years or older with heart disease , assessed the effects of a disease management program on physical functioning , symptom experience , and psychosocial status . METHODS Women were r and omly assigned to control or program groups . Six to eight women met weekly with a health educator and peer leader over 4 weeks to learn self-regulation skills with physical activity as the focus . Evaluative data were collected through telephone interviews , physical assessment s , and medical records at baseline and 4 and 12 months post baseline . RESULTS At 12 months , compared with controls , program women were less symptomatic ( p < .01 ) , scored better on the physical dimension of the Sickness Impact Profile ( SIP ; p < 0.05 ) , had improved ambulation as measured by the 6-minute walk ( p < 0.01 ) , and lost more body weight ( p < .001 ) . No differences related to psychosocial factors as measured by the SIP were noted . CONCLUSION A self-regulation-based program that was provided to older women with heart disease and that focused on physical activity and disease management problems salient to them , improved their physical functioning and symptom experience . Psychosocial benefit was not evident and may be a result of measurement error or due to insufficient program time spent on psychosocial aspects of functioning
There were no significant effects of interventions on mean blood pressure or cholesterol levels , prescribing , smoking status or body mass index .
There was some suggestion of a " ceiling effect " whereby interventions have a diminishing beneficial effect once certain levels of risk factor management are reached .
There is weak evidence that regular planned recall of patients for appointments , structured monitoring of risk factors and prescribing , and education for patients can be effective in increasing the proportions of patients within target levels for cholesterol control and blood pressure .
BACKGROUND Ischaemic heart disease ( IHD ) is a major cause of mortality and morbidity and its prevalence is set to increase .
Secondary prevention aims to prevent subsequent acute events in people with established IHD .
While the benefits of individual medical and lifestyle interventions is established , the effectiveness of interventions which seek to improve the way secondary preventive care is delivered in primary care or community setting s is less so .
OBJECTIVES To assess the effectiveness of service organisation interventions , identifying which types and elements of service change are associated with most improvement in clinician and patient adherence to secondary prevention recommendations relating to risk factor levels and monitoring ( blood pressure , cholesterol and lifestyle factors such as diet , exercise , smoking and obesity ) and appropriate prophylactic medication .