(RxWiki News) An effective option for aiding high-risk patients suffering from cardiovascular disease may be an individualized treatment plan from a nurse-led team focused on reducing heart disease risk factors.
Though awareness of heart disease has improved in recent years, patients still tend to do a poor job at reducing risk factors such as making dietary changes to lower cholesterol and blood pressure.
"Exercise and make healthier eating choices to lower your heart risk."
Jerilyn K. Allen, study leader and a registered nurse from Johns Hopkins University School of Nursing, found that a comprehensive program led by a nurse practitioner and community health worker could better help patients with heart disease improve blood pressure, cholesterol and glycated hemoglobin in those with type 2 diabetes.
During the randomized controlled trial researchers enrolled 525 patients with documented cardiovascular disease. The participants had type 2 diabetes, high cholesterol or hypertension, and were not managing risk factors that met goals established by national guidelines.
Half of the patients were assigned to care from a nurse-led team in urban community health centers, and received aggressive medication management and tailored educational and behavioral counseling for lifestyle modification, and addressing barriers to adherence. The remainder received usual care from a primary care provider.
Compared to the control group, participants that received care from the nurse-led team had a significantly greater 12-month reduction in total cholesterol, with a difference of 20 mg/dL, bad LDL cholesterol, with an average reduction of 16 mg/dL, and an average triglycerides drop of 16 mg/dL.
Patients in the nurse-led group also experienced an average systolic blood pressure decrease of 6 mm Hg, a diastolic blood pressure reduction of 3 mm Hg, and a half percent decrease in HbA1c, a test that measures sugar in the blood.
Researchers also found that the patients in the group that saw nurse practitioners had an improved perception of the quality of their chronic illness care, leading them to conclude that the individualized regimens can be effective for high-risk patients.
The research was recently published in Circulation: Cardiovascular Quality and Outcomes, a publication of the American Heart Association.