Document Detail


Impact of medical consultation frequency on modifiable risk factors and medications at 12months after acute coronary syndrome in the CHOICE randomised controlled trial.
MedLine Citation:
PMID:  20444512     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: We aimed to determine whether the frequency of General Practitioner and Cardiologist consultations impacted on improvements in risk factors in Choice of Health Options in Reducing Cardiovascular Events (CHOICE) randomised controlled trial.
METHODS: Retrospective subgroup analysis of single-blind randomised controlled trial. We included acute coronary syndrome survivors not accessing cardiac rehabilitation in the CHOICE trial whose General Practitioner or Cardiologist returned a visit frequency survey. The CHOICE group participated in tailored risk factor reduction packaged as clinic visit plus 3 months telephone support. Controls participated in physician-directed usual medical care. We compared total cholesterol, systolic blood pressure, smoking status, physical activity, number of modifiable risk factors and medications with frequency of medical consultations at baseline and 12months.
RESULTS: Most control and CHOICE patients saw their General Practitioner ≥5 times (85% vs 90%) and Cardiologist at least once (65% vs 57%). CHOICE patients had a significantly better modifiable risk profile (factor levels and multiples) and more patients were on evidence-based medications at 12months compared to controls. In CHOICE, the significant reduction in total cholesterol was unrelated to medical visits but lower systolic blood pressure was significant in patients who saw their General Practitioner ≥5 compared with ≤4 times. In controls, frequency of medical visits was not associated with any changes in risk profile.
CONCLUSIONS: Acute coronary syndrome survivors receiving frequent medical follow-up without packaged secondary prevention had no improvement in multiple risk factors over 12months. CHOICE patients who saw their doctors frequently were more likely to have significantly reduced systolic blood pressure and be on evidence-based medications.
Authors:
Julie Redfern; Monique Menzies; Tom Briffa; S B Freedman
Publication Detail:
Type:  Journal Article     Date:  2010-05-04
Journal Detail:
Title:  International journal of cardiology     Volume:  145     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  481-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Vascular Biology Group, ANZAC Research Institute, University of Sydney, Australia; Faculty of Medicine, University of Sydney, Sydney, Australia.
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