Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease

2.50
Hdl Handle:
http://hdl.handle.net/10755/163844
Category:
Abstract
Type:
Article
Level of Evidence:
Systematic Review
Research Approach:
Translational Research/Evidence-based Practice
Title:
Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease
Author(s):
Page, Tamara; Lockwood, Craig; Conroy-Hiller, Tiffany
Author Details:
Tamara Page, RN, BN, HyperbaricNursCert, GradDipNSc(HighDep), Nursing and Patient Care Services, Royal Adelaide Hospital, North Terrace, Adelaide, Australia, email: tpage@mail.rah.sa.gov.au; Craig Lockwood, RN, BN, GradDipNSc(ClinNurs), MNSc; Tiffany Conroy-Hiller, RN, BN, DipBusFLM
Abstract:
Background: Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives: The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria: This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results: Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that met the inclusion criteria. Two studies addressed nurse-led clinics for patients diagnosed with angina, one looked at medication administration and the other looked at educational plans. A further four studies compared secondary preventative care with a nurse-led clinic and general practitioner clinic. One specifically compared usual care versus shared care introduced by nurses for patients awaiting coronary artery bypass grafting. Of the remaining three studies, two have been combined in the results section, as they are an interim report and a final report of the same study. Because of inconsistencies in reporting styles and outcome measurements, meta-analysis could not be performed on all outcomes. However, a narrative summary of each study and comparisons of specific outcomes assessed from within each study has been developed. Although not all outcomes obtained statistical significance, nurse-led clinics were at least as effective as general practitioner clinics for most outcomes. Recommendations: The following recommendations are made: 1) The use of nurse-led clinics is recommended for patients with coronary heart disease (Level II).
2) Utilise nurse-led clinics to increase clinic attendance and follow-up rates (Level II). 3) Nurse-led clinics are recommended for patients who require lifestyle changes to decrease their risk of adverse outcomes associated with coronary heart disease (Level II).
Keywords:
Coronary Disease; Nurse-led; Patient education
Repository Posting Date:
27-Oct-2011
Date of Publication:
2005
Citation:
Page, T., Lockwood, C., & Conroy-Hiller, T. (2005). Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease.�International Journal Of Evidence-Based Healthcare,�3(1), 2-26.
Publisher:
Wiley-Blackwell
Conference Date:
2006
Conference Name:
Joanna Briggs Institute 2006 International Convention
Conference Host:
Joanna Briggs Institute
Conference Location:
Hilton Adelaide, South Australia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typeArticleen_GB
dc.evidence.levelSystematic Reviewen_US
dc.research.approachTranslational Research/Evidence-based Practiceen_US
dc.titleEffectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart diseaseen_GB
dc.contributor.authorPage, Tamaraen_US
dc.contributor.authorLockwood, Craigen_US
dc.contributor.authorConroy-Hiller, Tiffanyen_US
dc.author.detailsTamara Page, RN, BN, HyperbaricNursCert, GradDipNSc(HighDep), Nursing and Patient Care Services, Royal Adelaide Hospital, North Terrace, Adelaide, Australia, email: tpage@mail.rah.sa.gov.au; Craig Lockwood, RN, BN, GradDipNSc(ClinNurs), MNSc; Tiffany Conroy-Hiller, RN, BN, DipBusFLMen_US
dc.identifier.urihttp://hdl.handle.net/10755/163844-
dc.description.abstractBackground: Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives: The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria: This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results: Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that met the inclusion criteria. Two studies addressed nurse-led clinics for patients diagnosed with angina, one looked at medication administration and the other looked at educational plans. A further four studies compared secondary preventative care with a nurse-led clinic and general practitioner clinic. One specifically compared usual care versus shared care introduced by nurses for patients awaiting coronary artery bypass grafting. Of the remaining three studies, two have been combined in the results section, as they are an interim report and a final report of the same study. Because of inconsistencies in reporting styles and outcome measurements, meta-analysis could not be performed on all outcomes. However, a narrative summary of each study and comparisons of specific outcomes assessed from within each study has been developed. Although not all outcomes obtained statistical significance, nurse-led clinics were at least as effective as general practitioner clinics for most outcomes. Recommendations: The following recommendations are made: 1) The use of nurse-led clinics is recommended for patients with coronary heart disease (Level II).<br/>2) Utilise nurse-led clinics to increase clinic attendance and follow-up rates (Level II). 3) Nurse-led clinics are recommended for patients who require lifestyle changes to decrease their risk of adverse outcomes associated with coronary heart disease (Level II).en_GB
dc.subjectCoronary Diseaseen_US
dc.subjectNurse-leden_US
dc.subjectPatient educationen_US
dc.date.available2011-10-27T11:30:35Z-
dc.date.issued2005en_GB
dc.date.accessioned2011-10-27T11:30:35Z-
dc.identifier.citationPage, T., Lockwood, C., & Conroy-Hiller, T. (2005). Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease.�International Journal Of Evidence-Based Healthcare,�3(1), 2-26.en_US
dc.publisherWiley-Blackwellen_US
dc.identifier.issn1744-1595-
dc.conference.date2006-
dc.conference.nameJoanna Briggs Institute 2006 International Convention-
dc.conference.hostJoanna Briggs Institute-
dc.conference.locationHilton Adelaide, South Australia-
dc.identifier.citationPage, T., Lockwood, C., & Conroy-Hiller, T. (2005). Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease.�International Journal Of Evidence-Based Healthcare,�3(1), 2-26.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
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