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Observational Study
. 2018 Aug 15;18(1):167.
doi: 10.1186/s12872-018-0907-0.

Tailored nurse-led cardiac rehabilitation after myocardial infarction results in better risk factor control at one year compared to traditional care: a retrospective observational study

Halldora Ögmundsdottir Michelsen  1   2 , Marie Nilsson  3 , Fredrik Scherstén  3 , Ingela Sjölin  3   4 , Alexandru Schiopu  3   4 , Margret Leosdottir  3   4
Affiliations
Observational Study

Tailored nurse-led cardiac rehabilitation after myocardial infarction results in better risk factor control at one year compared to traditional care: a retrospective observational study

Halldora Ögmundsdottir Michelsen et al. BMC Cardiovasc Disord. .

Abstract

Background: Cardiac rehabilitation improves prognosis after an acute myocardial infarction (AMI), however, the optimal method of implementation is unknown. The aim of the study was to evaluate the effect of individually-tailored, nurse-led cardiac rehabilitation on patient outcomes.

Method: This single-centre retrospective observational study included 217 patients (62 ± 9 years, 73% men). All patients attended cardiac rehabilitation including at least two follow-up consultations with a nurse. Patients receiving traditional care (n = 105) had a routine cardiologist consultation, while for those receiving tailored care (n = 112) their need for a cardiologist consultation was individually evaluated by the nurses. Regression analysis was used to analyse risk factor control and hospital readmissions at one year.

Results: Patients in the tailored group achieved better control of total cholesterol (- 0.1 vs + 0.4 mmol/L change between baseline (time of index event) and 12-14-month follow-up, (p = 0.01), LDL cholesterol (- 0.1 vs + 0.2 mmol/L, p = 0.02) and systolic blood pressure (- 2.1 vs + 4.3 mmHg, p = 0.01). Active smokers, at baseline, were more often smoke-free at one-year in the tailored group [OR 0.32 (0.1-1.0), p = 0.05]. There was a no significant difference in re-admissions during the first year of follow-up. In the tailored group 60% of the patients had a cardiologist consultation compared to 98% in the traditional group (p < 0.001). The number of nurse visits was the same in both groups, while the number of telephone contacts was 38% higher in the tailored group (p = 0.02).

Conclusion: A tailored, nurse-led cardiac rehabilitation programme can improve risk factor management in post-AMI patients.

Keywords: Acute myocardial infarction; Cardiac rehabilitation; Cardiovascular risk factors; Nurse-led care; Secondary prevention.

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Conflict of interest statement

Ethics approval and consent to participate

The Regional Ethical Review Board at Lund University approved the study (Dnr 2016/494).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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