A randomised controlled trial to evaluate a nurse-led programme of support and lifestyle management for patients awaiting cardiac surgery 'Fit for surgery: Fit for life' study

Abstract

Background: The 'Fit For Surgery' programme was based on previous studies suggesting improvement in risk factors contributing to coronary disease while patients wait for cardiac surgery.

Aim: To evaluate our nurse-led programme in a randomised controlled trial with 188 patients.

Methods: Patients listed for coronary artery bypass surgery with at least one poorly controlled risk factor were randomised to standard care or the intervention which provided lifestyle counselling and preparation for surgery at monthly intervals. Primary outcome measurements were anxiety, blood pressure, cholesterol, length of stay and body mass index. Costs of the intervention were also collected.

Results: For both groups blood pressure and total cholesterol improved (Blood pressure mm Hg (Control -9.11 (CI -4.89, -13.33); Intervention -13.02 (CI -8.76, -U17.29) both p<0.01); total cholesterol (Control -0.20 (CI -0.03, -0.37) p=0.02, Intervention -0.18 (CI -0.02, -0.34) p=0.03). However there were no significant differences between the groups. Cost minimization analysis showed that the total costs were less in the intervention group due to fewer admissions (total costs pounds 10,754 (3746) v pounds 13,047 (5835), CI -3743, -843; p=0.002).

Conclusions: The nurse-led programme did not appear to reduce risk factors prior to coronary artery bypass surgery. However, the intervention appears to reduce overall healthcare utilization.