NCC demonstrated to have an effect on a small number of outcomes .
NCC that incorporated blood pressure monitoring , cholesterol control and smoking cessation has an impact on the improvement of secondary prevention .
Current guidelines on secondary prevention of cardiovascular disease recommend nurse-coordinated care ( NCC ) as an effective intervention .
However , NCC programmes differ widely and the efficacy of NCC components has not been studied .
A Multicenter, Randomized Trial of a Nurse-Led, Home-Based Intervention for Optimal Secondary Cardiac Prevention Suggests Some Benefits for Men but Not for Women: The Young at Heart Study
Background —We examined the impact of a prolonged secondary prevention program on recurrent hospitalization in cardiac patients with private health insurance . Methods and Results —The Young at Heart multicenter , r and omized , controlled trial compared usual postdischarge care ( UC ) with nurse-led , home-based intervention ( HBI ) . The primary end point was rate of all-cause hospital stay ( 31.5±7.5 months follow-up ) . In total , 602 patients ( aged 70±10 years , 72 % men ) were r and omized to UC  ( n=296 ) or HBI ( n=306 , 96 % received ≥1 home visit ) . Overall , 42 patients ( 7.0 % ) died , and 492 patients ( 82 % ) accumulated 2397 all-cause hospitalizations associated with 10 258 hospital days costing > $ 17 million . There were minimal group differences ( HBI versus UC ) in the primary end point of all-cause hospital stay ( 5405 versus 4853 days ; median [ interquartile range ] , 0.08 [ 0.03–0.17 ] versus 0.07 [0.03–0.13]/patient per month ) . There were similar trends with respect to all hospitalizations ( 1197 versus 1200 ; P=0.802 ) and associated costs ( $ 8.66 versus $ 8.58 million ; P=0.375 ) . At 2 years , however , more HBI versus UC ( 39 % versus 27 % ; odds ratio , 1.67 ; 95 % confidence interval , 1.15–2.41 ; P=0.007 ) patients were assessed as stable and optimally managed . For women , HBI outcomes were predominantly worse than UC outcomes . In men , HBI was associated with reduced risk of cardiovascular hospitalization ( adjusted hazard ratio , 0.68 ; 95 % confidence interval , 0.46–0.99 ; P=0.044 ) with less cardiovascular hospitalizations ( 192 versus 269 ; P=0.054 ) and costs ( $ 2.49 versus $ 3.53 million ; P=0.046 ) . Conclusions —HBI did not reduce recurrent all-cause hospitalization compared with UC in privately insured cardiac patients overall . However , it did convey some benefits in cardiac outcomes for men . Clinical Trial Registration —Australian New Zeal and Clinical Trials Registry Unique Identifier : 12608000014358 . URL : http://www.anzctr.org.au/trial_view.aspx?id=82509
NCC demonstrated to have an effect on a small number of outcomes .
NCC that incorporated blood pressure monitoring , cholesterol control and smoking cessation has an impact on the improvement of secondary prevention .
Current guidelines on secondary prevention of cardiovascular disease recommend nurse-coordinated care ( NCC ) as an effective intervention .
However , NCC programmes differ widely and the efficacy of NCC components has not been studied .