Coronary Artery Disease
Conditions
Keywords
coronary artery bypass surgery, risk factors, nurse-led secondary prevention, prehabilitation, waiting period
Brief summary
The time spent waiting for heart surgery can be extremely stressful. This programme aims to address this by providing a home-based, nurse-led support and education programme. Patients will be followed up in their own homes monthly by a cardiac nurse and given lifestyle advice and information to prepare them for surgery. This will be evaluated to test whether providing this support improves patients' anxiety and quality of life while they wait and also whether their blood pressure, weight and cholesterol are reduced and they have a smoother recovery as a consequence.
Detailed description
While waiting for coronary artery bypass graft (CABG) surgery many patients receive little if any medical and nursing input, at a time which is very stressful for them and their families. This randomised controlled trial will test whether a home-based, nurse-led support and education programme for patients waiting for such surgery can optimise mental and physical fitness and improve coronary heart disease risk factors by addressing anxiety, hypertension, obesity, diabetes and serum cholesterol in the waiting period. Patients will be followed up in their own homes monthly by a cardiac nurse and given lifestyle advice and information to prepare them for surgery. Primary outcome measurements will be anxiety, length of stay, blood pressure, cholesterol, blood glucose, smoking and body mass index. Secondary outcomes will be quality of life, and post-operative complications. Economic analysis and qualitative assessment of patients' opinion of the programme will also be performed.
Interventions
BEHAVIORALa nurse led home-based education and support programme
Sponsors
British Heart Foundation
Royal Brompton & Harefield NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
0 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients waiting for first time cardiac bypass surgery * Able to read and understand English
Exclusion criteria
* Patients living outside designated geographical area (\>1.5 hours drive from hospitals) * Patients having surgery other than first time coronary artery bypass grafts * Patients unable to read and understand English * Patients with life-threatening significant non-cardiovascular disease e.g. cancer * All risk factors under control (blood pressure \<140 systolic and/or \< 90 diastolic and/or serum cholesterol \<5 mmol/L and/or blood glucose \< 7mmol/L and anxiety score \< 8 on the Hospital Anxiety and Depression Scale).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Anxiety | — |
| Length of hospital stay | — |
| Changes to blood pressure, smoking rate, serum cholesterol, body mass index and blood glucose from baseline | — |
Secondary
| Measure | Time frame |
|---|---|
| Quality of life | — |
| Post-operative complications (cerebrovascular accident [CVA], myocardial infarction [MI], infection (wound & chest), arrhythmia requiring either formal resuscitation, pharmacological intervention or pacing) | — |
| Patients' perspective of the impact of the programme on their support and information needs (qualitative interview) | — |
Countries
United Kingdom
Outcome results
None listed