Program improves care of heart disease patients
By Will Boggs, MD
NEW YORK (Reuters Health) - Heart disease management programs are effective in the primary care setting, according to a report in the November issue of Heart.
Disease management programs, led by nurse specialist, for people with coronary heart disease and heart failure "result in improved care and quality of life," Dr. Kamlesh Khunti from the University of Leicester, UK told Reuters Health.
Khunti and associated investigated the effect of a disease management program for 1, 316 patients with coronary heart disease, chronic heart failure, or both, from 20 primary care practices. The patients were randomly assigned to participate in the disease management program or to regular care (the control group).
Significantly more patients in the disease management group than in the control group had an assessment of their blood pressure, which was adequately controlled at 12 months of follow-up, the authors report.
Patients in the disease management group were also more likely to participate in a smoking cessation program and were more likely to have a drop in their blood cholesterol level to below 5 mmol/L compared with patients in the control group.
More than one third (36.5 percent) of the patients in the intervention group with presumed but previously unconfirmed heart failure underwent echocardiographic examination, but only 10 percent of similar patients in the control group had echocardiograms.
Patients with coronary heart disease (but not those with chronic heart failure) showed significant improvements in quality of life evaluations after 12 months of participation in the disease management program compared with patients in the control group, the researchers note, and improvement in angina (cardiac chest pain) was significantly better for the intervention group patients than for the control patients.
Khunti added that his group has completed a cost-effectiveness study of their disease management program and that results should be published soon.
SOURCE: Heart, November 2007.