Secondary prevention programme of ischaemic heart disease in the elderly: A randomised clinical trial

Background Elderly patients have been underrepresented in secondary cardiovascular prevention programmes. This study aimed to ascertain the effects of a secondary coronary disease prevention programme in these patients. Design Open randomised intervention study with parallel groups. Methods One hundred and twenty-seven patients aged ≥70 years with a recent acute coronary syndrome were randomised to a protocolised clinical intervention plus usual care (intervention group, n = 64) or to usual care alone (control group, n = 63). Patients were assessed at baseline and after 12 months. The main outcome was the percentage of patients with optimal risk factor control after 12 months of follow-up. Secondary outcomes included changes in Mediterranean diet adherence, quality of life and functionality. Mortality was evaluated three years after the end of the intervention. Results One hundred and six patients (83.4%) completed 12 months of follow-up (54 in the intervention group and 52 in the control group). At the end of intervention, 34.2% more patients in the intervention group had achieved optimal risk factor control with a number needed to treat of 3 (relative risk 2.18, 95% confidence interval 1.36 to 3.50). The intervention group improved adherence to the Mediterranean diet ( p = 0.013) and functionality assessed by the Short Physical Performance Battery ( p = 0.047). No differences between groups were found in quality of life (Short-Form 36 Health Survey) or mortality after three years (hazard ratio 1.19, 95% confidence interval 0.41 to 3.45). Conclusions A secondary coronary disease prevention programme in elderly patients with a recent acute coronary syndrome improved risk factor control, Mediterranean diet adherence and functionality.

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Effect of a Sleep Hygiene Education Program Using Telephone Follow-up Method on the Sleep Quality of the Elderly

Salmand ◽

10.32598/sija.15.4.2895.1 ◽

2021 ◽

Vol 15 (4) ◽

pp. 484-495

Author(s):

Maryam Moradi ◽

◽

Hamideh Mohammadzadeh ◽

Reza Noori ◽

Kokab Basiri Moghadam ◽

...

Keyword(s):

Sleep Quality ◽

Education Program ◽

Intervention Group ◽

The Elderly ◽

Sleep Hygiene ◽

Control Group ◽

Hygiene Education ◽

And Control

Objectives: Low quality sleep is one of the most common problems in old age. The present study aims to determine the effect of a sleep hygiene education program using Telephone Follow-Up (TFU) method on the sleep quality of the elderly. Methods & Materials: This quasi-experimental study was conducted on 80 eligible elderly people aged 60-74 years who were selected using a systematic random sampling method and were randomly assigned into intervention and control groups. The intervention group received a one-hour face-to-face education session on sleep hygiene. The TFU were carried out two times per week in the first month and once a week in the second month after intervention. The control group received routine care. The data collection tools were a demographic form and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI was completed for both groups immediately after the second month. Results: There was no statistically significant difference in the mean PSQI score before intervention in the intervention (8.02) and control (7.47) groups (P=0.32), but after the intervention, the mean PSQI score in the intervention group (5.42) was significantly reduced compared to the control group (7.67) (P<0.001). Conclusion: Sleep hygiene education program based on TFU improves the sleep quality of the elderly. It is recommended that health care providers use this method to improve the sleep quality of the elderly.

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Effects of an intensive long-term prevention programme after myocardial infarction – a randomized trial

European Journal of Preventive Cardiology ◽

10.1177/2047487318781109 ◽

2018 ◽

Vol 26 (5) ◽

pp. 522-530 ◽

Cited By ~ 8

Author(s):

Harm Wienbergen ◽

Andreas Fach ◽

Sven Meyer ◽

Jochen Meyer ◽

Janina Stehmeier ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Infarction ◽

Risk Factor ◽

Usual Care ◽

Randomized Trial ◽

Prevention Programme ◽

Global Risk ◽

Risk Factor Control

Background Long-term risk factor control after myocardial infarction (MI) is currently inadequate and there is an unmet need for effective secondary prevention programmes. Design and methods It was the aim of the study to compare a 12-month intensive prevention programme (IPP), coordinated by prevention assistants and including education sessions, telephone visits and telemetric risk factor control, with usual care after MI. Three hundred and ten patients were randomized to IPP vs. usual care one month after hospital discharge for MI in two German heart centres. Primary study endpoint was the IPP Prevention Score (0–15 points) quantifying global risk factor control. Results Global risk factor control was strongly improved directly after MI before the beginning of the randomized study (30% increase IPP Prevention Score). During the 12-month course of the randomized trial the IPP Prevention Score was improved by a further 14.3% in the IPP group ( p < 0.001), while it decreased by 11.8% in the usual care group ( p < 0.001). IPP significantly reduced smoking, low-density lipoprotein cholesterol, systolic blood pressure and physical inactivity compared with usual care ( p < 0.05). Step counters with online documentation were used by the majority of patients (80%). Quality of life was significantly improved by IPP ( p < 0.05). The composite endpoint of adverse clinical events was slightly lower in the IPP group during 12 months (13.8% vs. 18.9%, p = 0.25). Conclusions A novel intensive prevention programme after MI, coordinated by prevention assistants and using personal teachings and telemetric strategies for 12 months, was significantly superior to usual care in providing sustainable risk factor control and better quality of life.

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Using Telemedicine to Improve the Quality of Life of Parents of Infants With CHD Surgery After Discharge

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzab133 ◽

2021 ◽

Author(s):

Qi-Liang Zhang ◽

Yu-Qing Lei ◽

Jian-Feng Liu ◽

Hua Cao ◽

Qiang Chen

Keyword(s):

Quality Of Life ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Intervention Group ◽

Control Group ◽

Educational Levels ◽

Education Levels

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P<0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P<0.05), while the scores of parents in the control group were similar at one month after discharge (P>0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P>0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P<0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P<0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.

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Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study

European Journal of Cardiovascular Nursing ◽

10.1177/1474515119880062 ◽

2019 ◽

Vol 19 (2) ◽

pp. 134-141 ◽

Cited By ~ 1

Author(s):

Lena Bosselmann ◽

Stella V Fangauf ◽

Birgit Herbeck Belnap ◽

Mira-Lynn Chavanon ◽

Jonas Nagel ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Collaborative Care ◽

Intervention Group ◽

Psychosocial Risk ◽

Control Group ◽

Risk Factor Control ◽

Care Intervention

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.

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Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors

Integrative Cancer Therapies ◽

10.1177/1534735420924757 ◽

2020 ◽

Vol 19 ◽

pp. 153473542092475

Author(s):

Julia Ruiz-Vozmediano ◽

Sarah Löhnchen ◽

Lucas Jurado ◽

Rosario Recio ◽

Andrea Rodríguez-Carrillo ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Mediterranean Diet ◽

Breast Cancer Survivors ◽

Intervention Program ◽

Intervention Group ◽

Control Group ◽

Cancer Symptoms

Background: Integrative oncology has proven to be a useful approach to control cancer symptoms and improve the quality of life (QoL) and overall health of patients, delivering integrated patient care at both physical and emotional levels. The objective of this randomized trial was to evaluate the effects of a triple intervention program on the QoL and lifestyle of women with breast cancer. Methods: Seventy-five survivors of stage IIA-IIB breast cancer were randomized into 2 groups. The intervention group (IG) received a 6-month dietary, exercise, and mindfulness program that was not offered to the control group (CG). Data were gathered at baseline and at 6 months postintervention on QoL and adherence to Mediterranean diet using clinical markers and validated questionnaires. Between-group differences at baseline and 3 months postintervention were analyzed using Student’s t test for related samples and the Wilcoxon and Mann-Whitney U tests. Results: At 6 months postintervention, the IG showed significant improvements versus CG in physical functioning ( p = .027), role functioning ( p = .028), and Mediterranean diet adherence ( p = .02) and a significant reduction in body mass index ( p = .04) and weight ( p = .05), with a mean weight loss of 0.7 kg versus a gain of 0.55 kg by the CG ( p = .05). Dyspnea symptoms were also increased in the CG versus IG ( p = .066). Conclusions: These results demonstrate that an integrative dietary, physical activity, and mindfulness program enhances the QoL and healthy lifestyle of stage IIA-IIB breast cancer survivors. Cancer symptoms may be better managed by the implementation of multimodal rather than isolated interventions.

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A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

Canadian Respiratory Journal ◽

10.1155/2010/327650 ◽

2010 ◽

Vol 17 (2) ◽

pp. 67-73 ◽

Cited By ~ 27

Author(s):

Shawna L McGhan ◽

Eric Wong ◽

Heather M Sharpe ◽

Patrick A Hessel ◽

Puish Mandhane ◽

...

Keyword(s):

Quality Of Life ◽

Usual Care ◽

Education Program ◽

Intervention Group ◽

Asthma Management ◽

Control Group ◽

Asthma Education ◽

Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

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A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with cp-BPPV: A randomised controlled trial in primary care.

10.21203/rs.3.rs-36678/v2 ◽

2020 ◽

Author(s):

Ricard Carrillo Muñoz ◽

Jose Luis Ballve Moreno ◽

Ivan Villar Balboa ◽

Yolanda Rando Matos ◽

Oriol Cunillera Puertolas ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Intervention Group ◽

Control Group ◽

Perceived Disability ◽

Self Perceptions ◽

Perceptions Of Disability ◽

The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability. Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men ( P <0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus ( P =0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration : ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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CT of the coronary arteries in patients with non-coronary chest pain. An educational intervention aimed at improving reliance and reducing episodes of recurring chest pain

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.221 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

I Krohn ◽

CB Rygh ◽

TM Norekvaal

Keyword(s):

Quality Of Life ◽

Chest Pain ◽

False Negative ◽

Intervention Group ◽

Control Group ◽

Ct Examination ◽

Examination Result ◽

Low Probability

Abstract Funding Acknowledgements Type of funding sources: None. Background Chest pain is a symptom closely linked to coronary disease (CAD) and a common complaint in the general practitioner’s office. Nevertheless, most of these complaints are benign and of non-coronary origin. Computed Tomography (CT) is the main diagnostic tool to investigate the coronary arteries, an examination with a low probability of false-negative result (<1%). Despite negative findings of CAD, this patient group still experience higher degree of morbidity and anxiety and decreased quality of life when compared to a population without chest pain. Purpose To determine the effect of an intervention for reliance in the CT-examination and recurring chest pain in patients with non-coronary chest pain in follow-up after one month. Methods Patients with chest pain, but with normal CT-findings, i.e. no CAD, were randomised into two groups. The intervention group received extended information about the examination, such as the reliability of the result due to CTs low probability of false-negative result and also the great prognostic value it provides. The examination result was then conveyed to the patient. The control group received standard care; i.e no extended information was given and the examination result was obtained from their general practitioner after one week. The effect of the intervention was measured with a specific question regarding reliance in the CT-examination and the Seattle Angina Questionnaire (SAQ) at follow-up after one month. Results The study included 92 patients; follow-up response rate was 80%. Of the participants were 63 females (68%), and the mean age was 51 years. Analysis showed that the intervention group had significantly higher reliance in the CT-examination (p = 0.016) and significantly reduced incidences of chest pain (p = 0.042) when compared to the control group at 1-month follow-up (Figure 1). Conclusion This intervention demonstrates that relatively simple actions may have a great impact on patient care. Providing patients with extended information and an early communication of CT results have a positive effect on reliance and chest pain after one month. Such an effect may lead to lower morbidity, less anxiety and a higher quality of life in this group. Further examinations after six or twelve months might provide additional knowledge of the long-term effect of the performed intervention. Abstract Figure 1

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A Remote Nutritional Intervention to Change the Dietary Habits of Patients Undergoing Ablation of Atrial Fibrillation: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/21436 ◽

2020 ◽

Vol 22 (12) ◽

pp. e21436

Author(s):

Leticia Goni ◽

Víctor de la O ◽

M Teresa Barrio-López ◽

Pablo Ramos ◽

Luis Tercedor ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Mediterranean Diet ◽

Retention Rate ◽

Intervention Group ◽

Nutritional Intervention ◽

Control Group ◽

Randomized Controlled ◽

The Mediterranean

Background The Prevention With Mediterranean Diet (PREDIMED) trial supported the effectiveness of a nutritional intervention conducted by a dietitian to prevent cardiovascular disease. However, the effect of a remote intervention to follow the Mediterranean diet has been less explored. Objective This study aims to assess the effectiveness of a remotely provided Mediterranean diet–based nutritional intervention in obtaining favorable dietary changes in the context of a secondary prevention trial of atrial fibrillation (AF). Methods The PREvention of recurrent arrhythmias with Mediterranean diet (PREDIMAR) study is a 2-year multicenter, randomized, controlled, single-blinded trial to assess the effect of the Mediterranean diet enriched with extra virgin olive oil (EVOO) on the prevention of atrial tachyarrhythmia recurrence after catheter ablation. Participants in sinus rhythm after ablation were randomly assigned to an intervention group (Mediterranean diet enriched with EVOO) or a control group (usual clinical care). The remote nutritional intervention included phone contacts (1 per 3 months) and web-based interventions with provision of dietary recommendations, and participants had access to a web page, a mobile app, and printed resources. The information is divided into 6 areas: Recommended foods, Menus, News and Online resources, Practical tips, Mediterranean diet classroom, and Your personal experience. At baseline and at 1-year and 2-year follow-up, the 14-item Mediterranean Diet Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire were collected by a dietitian by phone. Results A total of 720 subjects were randomized (365 to the intervention group, 355 to the control group). Up to September 2020, 560 subjects completed the first year (560/574, retention rate 95.6%) and 304 completed the second year (304/322, retention rate 94.4%) of the intervention. After 24 months of follow-up, increased adherence to the Mediterranean diet was observed in both groups, but the improvement was significantly higher in the intervention group than in the control group (net between-group difference: 1.8 points in the MEDAS questionnaire (95% CI 1.4-2.2; P<.001). Compared with the control group, the Mediterranean diet intervention group showed a significant increase in the consumption of fruits (P<.001), olive oil (P<.001), whole grain cereals (P=.002), pulses (P<.001), nuts (P<.001), white fish (P<.001), fatty fish (P<.001), and white meat (P=.007), and a significant reduction in refined cereals (P<.001), red and processed meat (P<.001), and sweets (P<.001) at 2 years of intervention. In terms of nutrients, the intervention group significantly increased their intake of omega-3 (P<.001) and fiber (P<.001), and they decreased their intake of carbohydrates (P=.02) and saturated fatty acids (P<.001) compared with the control group. Conclusions The remote nutritional intervention using a website and phone calls seems to be effective in increasing adherence to the Mediterranean diet pattern among AF patients treated with catheter ablation. Trial Registration ClinicalTrials.gov NCT03053843; https://www.clinicaltrials.gov/ct2/show/NCT03053843

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The Effect of Solution-Focused Counseling on Violence Rate and Quality of Life of Pregnant Women at Risk of Domestic Violence: A randomized Controlled Trial

10.21203/rs.3.rs-34762/v1 ◽

2020 ◽

Author(s):

Sepideh Din Mohammadi ◽

Mohsen Dadashi ◽

Elahe Ahmadnia ◽

leila Janani ◽

Roghieh Kharaghani

Keyword(s):

Quality Of Life ◽

At Risk ◽

Domestic Violence ◽

Pregnant Women ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Solution Focused

Abstract Background: Domestic violence is considered as one of the most common social problems, which can affect the quality of life of women. The problem of preventing and controlling this problem, especially during pregnancy, is one of the basic challenges of health systems. The aim of this study was to determine the effect of counseling based on conflict solution on the rate of violence and quality of life of pregnant women at risk of domestic violence. Methods: This study was a randomized controlled trial on 90 pregnant women, who were selected from maternity wards in health center number three in Zanjan city. Women who had inclusion criteria based on the domestic violence conflict tactics scale (CTS-2) selected with convenience sampling and randomly divided into two groups of intervention (45 people) and control (45 people) with a blocked randomization method. The intervention group received six counseling sessions with a solution-focused approach and the control group received no intervention. Study tool included demographic and reproductive questionnaires CTS- 2 and short form health survey (SF-36); which completed at baseline and six weeks follow-up in both groups. The results were analyzed by nonparametric ANCOVA using SPSS and R soft wares.Results: The results showed that there was a significant difference in the physical violence (P=0.001), psychological violence (P=0.001), and sexual violence (P=0.001) in the intervention group compared to the control group at six weeks follow- up. There were significant improvements in negotiation scores in the intervention group (P˂0.001). Moreover, there were significant differences in the quality of life scores (P=0.001), vitality (p=0.003), psychological health (p=0.004), bodily pain (p=0.014), physical functioning (p=0.023), and social functioning (p=0.019) between the two groups at the follow- up period.Conclusion: According to the result, individual counseling based on a solution-based approach reduces the amount of domestic violence and increases the quality of life of pregnant women at risk of violence.Trial registration: Iranian Registry of Clinical Trials IRCT2017040628352N4. Date of registration: August 20th 2017.

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