EUROACTION
Year Presented: 2006
Description: The goal of the study was to evaluate a nurse-led approach to lifestyle intervention among patients with or at high risk for coronary heart disease and their partners.
Drugs/Procedures Used: Hospitals and general practices in eight countries were randomized to usual care (n = 2,613 patients and 1,634 partners) or EuroAction intervention program (n = 2,778 patients and 1,632 partners). In the intervention group, a nurse-led intervention team sought to improve lifestyle, risk factors, and therapeutic management. Lifestyle and risk factors addressed included diet, physical activity, central obesity, blood pressure, cholesterol, and glucose.
Principal Findings: More patients in the intervention group met recommended fruit and vegetable intake guidelines (coronary disease cohort: 72% with intervention vs. 35% for usual care; high-risk cohort: 78% vs. 39%). Likewise, partners of those in the intervention group also more frequently met recommended fruit and vegetable intake guidelines (coronary disease cohort partners: 72% with intervention vs. 37% for usual care; high-risk cohort: 77% vs. 54%). Consumption of saturated fat to <10% of caloric intake was also reduced with the intervention group (coronary disease cohort: 55% with intervention vs. 40% for usual care) and consumption of oily fish was increased (≥3 times per week, coronary disease cohort: 17% with intervention vs. 8% for usual care). Physical activity targets of exercise 30-45 minutes 4-5 times per week were met more frequently in the intervention group (coronary disease cohort: 54% with intervention vs. 20% for usual care; high-risk cohort: 50% vs. 22%) and partners of the intervention group (coronary disease cohort: 41% with intervention vs. 27% for usual care; high-risk cohort: 44% vs. 25%). Blood pressure targets were more frequently met in the intervention group in both diabetic and nondiabetic patients. In the coronary disease cohort, total cholesterol targets of <5 mmol/L were similar in the intervention group (78%) and for the usual-care group (71%). Cardiac medication use was higher in the intervention group compared with the usual-care group. Among those who were smokers at the time of the coronary event, 58% of those in the intervention group stopped smoking versus 47% for usual care.
Interpretation: Among patients with or at high risk for coronary heart disease and their partners, use of a nurse-led prevention intervention program was associated with improvements in lifestyle modifications compared with usual care. The present trial is one of the first large-scale behavior modification/risk reduction studies to target not only coronary disease patients, but also the partners of these patients. Additional analysis is underway to further evaluate the cost and cost-effectiveness of the program.
Conditions
• Coronary heart disease
Therapies
• Behavior Modification
Study Design
Randomized.
Patients Enrolled: 8,657
Mean Follow-Up: One year
Patient Population: Acute coronary syndrome or stable coronary artery disease (coronary disease cohort) or at high risk for coronary artery disease or treated for hypertension of diabetes (high-risk cohort)
Summary Slide
Title: EUROACTION Trial
Presented by D.A. Wood, European Society of Cardiology Scientific Congress, September 2006.
Year Presented: 2006
Description: The goal of the study was to evaluate a nurse-led approach to lifestyle intervention among patients with or at high risk for coronary heart disease and their partners.
Drugs/Procedures Used: Hospitals and general practices in eight countries were randomized to usual care (n = 2,613 patients and 1,634 partners) or EuroAction intervention program (n = 2,778 patients and 1,632 partners). In the intervention group, a nurse-led intervention team sought to improve lifestyle, risk factors, and therapeutic management. Lifestyle and risk factors addressed included diet, physical activity, central obesity, blood pressure, cholesterol, and glucose.
Principal Findings: More patients in the intervention group met recommended fruit and vegetable intake guidelines (coronary disease cohort: 72% with intervention vs. 35% for usual care; high-risk cohort: 78% vs. 39%). Likewise, partners of those in the intervention group also more frequently met recommended fruit and vegetable intake guidelines (coronary disease cohort partners: 72% with intervention vs. 37% for usual care; high-risk cohort: 77% vs. 54%). Consumption of saturated fat to <10% of caloric intake was also reduced with the intervention group (coronary disease cohort: 55% with intervention vs. 40% for usual care) and consumption of oily fish was increased (≥3 times per week, coronary disease cohort: 17% with intervention vs. 8% for usual care). Physical activity targets of exercise 30-45 minutes 4-5 times per week were met more frequently in the intervention group (coronary disease cohort: 54% with intervention vs. 20% for usual care; high-risk cohort: 50% vs. 22%) and partners of the intervention group (coronary disease cohort: 41% with intervention vs. 27% for usual care; high-risk cohort: 44% vs. 25%). Blood pressure targets were more frequently met in the intervention group in both diabetic and nondiabetic patients. In the coronary disease cohort, total cholesterol targets of <5 mmol/L were similar in the intervention group (78%) and for the usual-care group (71%). Cardiac medication use was higher in the intervention group compared with the usual-care group. Among those who were smokers at the time of the coronary event, 58% of those in the intervention group stopped smoking versus 47% for usual care.
Interpretation: Among patients with or at high risk for coronary heart disease and their partners, use of a nurse-led prevention intervention program was associated with improvements in lifestyle modifications compared with usual care. The present trial is one of the first large-scale behavior modification/risk reduction studies to target not only coronary disease patients, but also the partners of these patients. Additional analysis is underway to further evaluate the cost and cost-effectiveness of the program.
Conditions
• Coronary heart disease
Therapies
• Behavior Modification
Study Design
Randomized.
Patients Enrolled: 8,657
Mean Follow-Up: One year
Patient Population: Acute coronary syndrome or stable coronary artery disease (coronary disease cohort) or at high risk for coronary artery disease or treated for hypertension of diabetes (high-risk cohort)
Summary Slide
Title: EUROACTION Trial
Presented by D.A. Wood, European Society of Cardiology Scientific Congress, September 2006.