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 .
[Smoking cessation among patients with acute heart disease. A randomised intervention project].
INTRODUCTION Our goal was to investigate whether ambulatory smoking cessation among patients in a cardiologic department would ( 1 ) reduce the number of smokers by at least 25 % after 12 months compared to a control group and ( 2 ) influence whether the individual patient was readmitted to hospital . We used a r and omised , controlled , prospect i ve intervention project design . MATERIAL S AND METHODS Everyone hospitalised during the project period was screened . Those who fulfilled the criteria for inclusion were r and omised for inclusion in either the intervention group or the  control group . Both groups were given the department 's smoking cessation information . In addition , the intervention group attended five ambulatory smoking cessation intervention sessions . Each patient 's smoking status was registered after 12 months . chi2-test and logistic regression analysis were used to test differences , associations and control of confounders . RESULTS In all , 3,982 patients were screened , 29.5 % of whom were smokers . The study included 105 patients : 54 in the intervention group and 51 in the control group . After 12 months , 52 % of those in the intervention group compared to 39 % in the control group had become non-smokers , which was non-significant ( p = 0,14 ) . Ischemic heart disease ( IHS ) was significantly associated with smoking cessation . After adjustment for this confounder , the result was enhanced ( p = 0,06 ) . Readmission to hospital was not affected by smoking cessation ( p = 0,73 ) . DISCUSSION Ambulatory smoking cessation intervention had no significant effect on smoking cessation on an unselected group of patients in a cardiologic hospital department . The project does indicate that ambulatory smoking cessation interventions could have an effect on patients with IHS
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 .