Reports From the Field: CM intervention help cardiac patients control cholesterol
December 1, 2002
Reports From the Field: CM intervention help cardiac patients control cholesterol
Patients who get follow-up care from a nurse after heart bypass surgery are more likely to control cholesterol and reduce the risk of further disease, according to a study from the Johns Hopkins University School of Nursing in Baltimore.1
The study followed 228 male and female heart patients. One group received the usual follow-up care, enhanced with cholesterol-lowering medication and written reports on cholesterol levels sent to the patient and the patient’s physicians.
In the other group, a nurse case manager offered individualized counseling, feedback on lifestyle modifications, and monitoring of cholesterol-lowering medications. The program included an outpatient visit, follow-up telephone calls, and communication with the patient’s physicians. The nurse case managers spent an average of less than five hours total per patient per year.
The nurse case manager monitored the effectiveness of the cholesterol-lowering medication, adjusted the dosage as needed, and prompted compliance in taking the medicine.
About 65% of the patients receiving case management achieved the recommended cholesterol level, compared to 35% in the group that received minimal intervention. Patients who were case managed also reported healthier diet and exercise patterns.
"Our research suggested that more aggressive treatment is needed to enable patient with a history of heart disease manage their cholesterol, improve their help, and avoid complications," says Jerilyn Allen, ScD, RN, professor at the school of nursing.
Reference
1. Allen J, Blumenthal R, Margolis S, et al. Nurse case management of hypercholesterolemia in patients with coronary artery disease: Results of a randomized clinical trial. Am Heart J 2002; 144(4): 678-686.