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| Intensive nursing care by an electronic followup system to promote secondary prevention after percutaneous coronary intervention: a randomized trial |
| Hu X, Zhu X, Gao L |
| Journal of Cardiopulmonary Rehabilitation and Prevention 2014 Nov-Dec;34(6):396-405 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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PURPOSE: To investigate the effectiveness of an intensive nursing care electronic followup system for cardiovascular risk management after percutaneous coronary intervention (PCI). METHODS: In total, 840 subjects who underwent PCI in a single hospital in Beijing between January 2010 and January 2012 were enrolled. All subjects were randomized into the control and intensive nursing care groups (n = 420 each group). Both groups received standard secondary prevention according to guidelines. The control group received regular followup while the intensive nursing care group was closely monitored and followed by specific nursing staff with the electronic followup system. RESULTS: In total, 807 subjects were followed up for 1 year. Compared with subjects in the control group, those in the intensive group had decreased levels of total cholesterol (3.99 +/- 1.08 versus 3.76 +/- 0.98; p < 0.05), systolic blood pressure (142.41 +/- 11.53 versus 135.71 +/- 14.57 mmHg; p < 0.05), low-density lipoprotein cholesterol (LDL-C) (2.72 +/- 1.01 versus 2.42 +/- 0.81; p < 0.05), and body mass index (25.13 +/- 5.12 versus 24.23 +/- 6.22; p < 0.05); a higher percentage with target LDL-C < 2.6 mmol/L (66.99% versus 47.88%; p < 0.05); increased use of medication including aspirin (96.51% versus 99.26%; p < 0.05), clopidogrel (87.53% verss 98.77%; p < 0.05), statins (52.62% versus 93.10%; p < 0.05), beta-blockers (48.63% versus 61.33%; p < 0.05), and angiotensin-converting enzyme inhibitors (32.92% versus 61.82%; p < 0.05); and better dietary control and physical exercise (55.66% versus 26.18%, p < 0.05; 62.56% versus 38.65%, p < 0.05). CONCLUSIONS: Intensive nursing care by the electronic followup system may lead to an improvement in quality of secondary prevention after PCI, including risk factor control, the use of medication, and self-management abilities.
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