Document Detail


A case-management program of medium intensity does not improve cardiovascular risk factor control in coronary artery disease patients: the Heartcare I trial.
MedLine Citation:
PMID:  11343668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Case-management programs for secondary prevention of coronary artery disease that utilize extensive resources can reduce cardiovascular risk factors, but less intensive approaches have failed to show benefits. This randomized trial evaluated whether a medium intensity case-management program improves risk factor control in patients with coronary artery disease. METHODS: We assigned 201 consecutive patients hospitalized for acute coronary events in the intensive care unit of University Hospital, Basel, Switzerland, to either a risk factor case-management program (n = 99) or care as usual (n = 102) using the patients' primary care physicians as the unit of randomization (cluster randomization). The case-management program consisted of an hour of counseling by a clinician during hospitalization and two short reminders by phone and mail 3 and 6 months later. Treatment decisions were left to patients and their primary care physicians. RESULTS: After 9 and 18 months of follow-up, there were no significant differences in lipid values, blood pressure control, fasting blood glucose, body-mass index, or number of smokers between the two groups. However, significantly more patients in the intervention group than in the care as usual group achieved target cholesterol values after 18 months (48% versus 27%, P = 0.002 and remained significant after Bonferroni-Holms correction) but not after 9 months of follow-up (31% versus 27%, P >0.2). CONCLUSION: This hospital-based case-management and outreach program, limited to counseling by a clinician, did not substantially improve cardiovascular risk factor control among patients hospitalized for coronary events.
Authors:
A Nordmann; I Heilmbauer; T Walker; B Martina; E Battegay
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  110     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-09     Completed Date:  2001-05-17     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  543-50     Citation Subset:  AIM; IM    
Affiliation:
Medical Outpatient Division, Department of Internal Medicine, University Hospital, Basel, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Body Mass Index
Case Management*
Cholesterol / blood
Coronary Disease / therapy*
Female
Hospitalization
Humans
Life Style
Male
Middle Aged
Motivation
Risk Factors
Chemical
Reg. No./Substance:
57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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