Evaluation of a postdischarge coronary artery disease management program

ObjectivesWe conducted a demonstration project to assess the value of a nurse practitioner (NP) based coronary artery disease management (CAD‐DM) program for patients with an acute coronary syndrome (ACS) or percutaneous coronary intervention.MethodsPatients were recruited to attend three 1‐h monthly visits. The intervention included assessment of clinical symptoms and guideline‐based treatments; education regarding CAD/ACS; review of nutrition, exercise, and appropriate referrals; and recognition of significant symptoms and emergency response.ResultsTwo hundred thirteen (84.5%) completed the program. Physician approval for patient participation was 99%. Average age was 63 ± 11 years, 70% were male, and 89% white. At baseline, 61% (n = 133) had one or more cardiopulmonary symptoms, which declined to 30% at 12 weeks, p < .001. Sixty‐nine percent attended cardiac rehabilitation or an exercise consult. Compared to the initial assessment, an additional 20% were at low‐density lipoprotein cholesterol < 70 mg/dL (p = .04), an additional 35% met exercise goals (p < .0001), and there was an improvement in the mental (baseline 49.7 vs. 12 weeks 53, p = .0015) and physical components (44 vs. 48, p = .002) of the SF‐12 health survey.ConclusionThis NP‐based CAD‐DM program was well received and participants demonstrated improvement in physical and mental health, and increased compliance with recommended lifestyle changes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112261/1/jaan12201.pd