Choice of Health Options in Prevention of Cardiovascular Events (CHOICE) Replication Study

Lis Neubeck¹, Ben Freedman², Nicole Lowres³, Karice Hyun⁴, Jessica Orchard⁵, Tom Briffa⁶, Adrian Bauman⁷, Kris Rogers⁸, Julie Redfern⁴

Affiliations

¹ School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland; Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; The George Institute for Global Health, Sydney, NSW, Australia. Electronic address: l.neubeck@napier.ac.uk.
² Heart Research Institute, University of Sydney, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Dept of Cardiology and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.
³ Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Heart Research Institute, University of Sydney, Sydney, NSW, Australia.
⁴ The George Institute for Global Health, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
⁵ School of Public Health, University of Sydney, Sydney, NSW, Australia.
⁶ School of Population Health, University of Western Australia, Sydney, NSW, Australia.
⁷ Dept of Cardiology and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia.
⁸ The George Institute for Global Health, Sydney, NSW, Australia.

PMID: 29100841
DOI: 10.1016/j.hlc.2017.09.016

Randomized Controlled Trial

Choice of Health Options in Prevention of Cardiovascular Events (CHOICE) Replication Study

Lis Neubeck et al. Heart Lung Circ. 2018 Dec.

. 2018 Dec;27(12):1406-1414.

doi: 10.1016/j.hlc.2017.09.016. Epub 2017 Oct 20.

Authors

Lis Neubeck¹, Ben Freedman², Nicole Lowres³, Karice Hyun⁴, Jessica Orchard⁵, Tom Briffa⁶, Adrian Bauman⁷, Kris Rogers⁸, Julie Redfern⁴

Affiliations

¹ School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland; Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; The George Institute for Global Health, Sydney, NSW, Australia. Electronic address: l.neubeck@napier.ac.uk.
² Heart Research Institute, University of Sydney, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Dept of Cardiology and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.
³ Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Heart Research Institute, University of Sydney, Sydney, NSW, Australia.
⁴ The George Institute for Global Health, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
⁵ School of Public Health, University of Sydney, Sydney, NSW, Australia.
⁶ School of Population Health, University of Western Australia, Sydney, NSW, Australia.
⁷ Dept of Cardiology and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia.
⁸ The George Institute for Global Health, Sydney, NSW, Australia.

PMID: 29100841
DOI: 10.1016/j.hlc.2017.09.016

Abstract

Background: Globally, attendance at cardiac rehabilitation (CR) is between 15 and 30%. Alternative models of individualised care are recommended to promote participation in CR, however there has been no prospective testing of different durations of such models. We aimed to replicate the previously proven Choice of Health Options In prevention of Cardiovascular Events (CHOICE) intervention, and to determine if an extended version (CHOICEplus) would confer additional benefits.

Methods: Acute coronary syndrome (ACS) survivors not accessing centre-based CR (n=203) were randomised to CHOICE for 3 months (n=100) or CHOICEplus for 24 months (n=103) at four urban hospitals. The program comprised telephone-based tailored risk-factor reduction.

Results: CHOICE and CHOICEplus were equivalent demographically and in risk profile at baseline. At 24 months, lipid profiles improved significantly and fewer patients had ≥3 risk factors above target compared to baseline in both groups. There were no significant differences between groups.

Conclusions: The 24-month CHOICEplus program did not confer additional benefit above the brief 3-month CHOICE intervention. However, participation in either CHOICE and CHOICEplus significantly improved cardiovascular risk profile in ACS survivors. Importantly, the study was feasible, and the intervention translated readily across four hospitals. Overall, this study adds to the existing evidence for brief individualised approaches to CR.

Keywords: Cardiac rehabilitation; Secondary prevention; Telehealth.

Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

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Choice of Health Options in Prevention of Cardiovascular Events (CHOICE) Replication Study

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Choice of Health Options in Prevention of Cardiovascular Events (CHOICE) Replication Study

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