Effect of a Telephone-Delivered Coronary Heart Disease Secondary Prevention Program (ProActive Heart) on Quality of Life and Health Behaviours: Primary Outcomes of a Randomised Controlled Trial
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Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.
To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.
Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).
Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05).
Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.
KeywordsMyocardial infarction Secondary prevention Telephone Intervention Health-related quality of life Physical activity Health behaviours
This study was funded by a National Health and Medical Research Council project grant #443222. Adrienne O’Neil is supported by a Post Graduate Award from the National Heart Foundation of Australia (PP 08 M4079). The funding bodies had no role in the design or conduct of the study, data extraction or data analyses. We thank The Prince Charles Hospital and Royal Brisbane and Women’s Hospital staff for their support of the study, and acknowledge the dedicated work of our health coaches, Dr Dominique Bird, Ms Brigid Hanley and Ms Bernice Kelly, as well as our telephone interviewers. We thank our research investigators, Professor Paul Scuffam, Ms Nancy Houston Miller and Professor John Bett. We are also grateful for Associate Professor Darren Walters’ support of the study.
Conflict of Interest Statement
The authors have no conflict of interest to disclose.
- 1.Smith Jr SC, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 Update: endorsed by the national heart, lung, and blood institute. Circulation. 2006;113(19):2363–72. May 16, 2006.PubMedCrossRefGoogle Scholar
- 2.Piepoli MF, CorrÃ U, Benzer W, Bjarnason-Wehrens B, Dendale P, Gaita D, et al. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the cardiac rehabilitation section of the European association of cardiovascular prevention and rehabilitation. Eur J Cardiovasc Prev Rehabil. 2010;17(1):1–17. 0.1097/HJR.0b013e3283313592.PubMedCrossRefGoogle Scholar
- 4.Joliffe J, Rees K, Taylor R, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease. Cochrane Review In: The Cochrane Library. 2003(1):1–41.Google Scholar
- 6.Davies P, Taylor F, Beswick A, Wise F, Moxham T, Rees K, et al. Promoting patient uptake and adherence in cardiac rehabilitation. The Cochrane Library. 2010(7).Google Scholar
- 10.British Heart Foundation. National Audit of Cardiac Rehabilitation 2011: an annual, BHF funded report into the provision and uptake of cardiac rehabilitation across England, Wales and Northern Ireland. 2011.Google Scholar
- 12.Neubeck L, Redfern Ju, Fernandez R, Briffa T, Bauman A, Freedman SB. Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review. J Cardiovasc Risk. 2009;16(3):281–9. June 1, 2009.Google Scholar
- 13.Blair J, Corrigal H, Angus NJ, Thompson DR, Leslie S. Home versus hospital-based cardiac rehabilitation: a systematic review. Rural Remote Heal. 2011;11(2):1532–49. Apr–Jun Epub Apr 6.Google Scholar
- 17.Heran BS, Chen JMH, Ebrahim S, Moxham T, Oldridge N, Rees K, et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2011. doi: 1002/14651858.CD001800.pub2. Issue 7. Art. No.: CD001800.
- 18.Hawkes AL, Atherton J, Taylor CB, Scuffham P, Eadie K. Houston Miller N, et al. Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart'): study protocol. Secondary prevention program for myocardial infarction patients. BMC Cardiovasc Disord. 2009;9:16–22.PubMedCrossRefGoogle Scholar
- 19.National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand. Guidelines for the management of acute coronary syndromes. MJA. 2006;184:S1–S30.Google Scholar
- 20.The Heart Foundation Australia Website. Available from: http://www.heartfoundation.org.au/Heart_Information/Information_by_Phone/Pages/default.aspx.
- 22.Bandura A. Social learning theory. Englewood Cliffs: Prentice Hall; 1977.Google Scholar
- 24.National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: guidelines for preventing cardiovascular events in people with coronary heart disease. National Heart Foundation of Australia; 2003.Google Scholar
- 25.National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Reducing risk in heart disease 2007 (updated 2008).Google Scholar
- 26.National Heart Foundation of Australia. My Heart My Life: a manual for patients with coronary heart disease. National Heart Foundation of Australia; 2007.Google Scholar
- 30.Australian Institute of Health and Welfare (AIHW). The Active Australia Survey: a guide and manual for implementation, analysis and reporting. Canberra: AIHW2003.Google Scholar
- 34.Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G. The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Aust N Z J Public Health. 2000;24(6):576–83.PubMedCrossRefGoogle Scholar
- 36.Moher D, Hopewell S, Schulz KF, Montori V, GÃ¸tzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ.340.Google Scholar
- 39.US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, CDC, National Center for Chronic Disease Prevention and Health Promotion 1996.Google Scholar