Effects of health advocacy, counseling, and activation among older coronary heart disease (CHD) patients.
OBJECTIVE
Coronary heart disease (CHD) is common and the majority of CHD patients are 65 years or older. There exist only a few randomized, controlled intervention studies on secondary prevention of CHD among elderly CHD patients. Our study assessed the effects of health advocacy, counseling, and activation programs with outcome variables of changes in the use of fats, lipid-lowering medications, frequency of exercise, cigarette smoking, serum cholesterol and triglyceride concentrations, blood pressure, and symptoms of late-life CHD among CHD patients of the Lieto Study.


METHODS
Randomized, controlled intervention study. Late-life (> or = 65 yrs) CHD patients were randomized into intervention group (IG) (n = 118) and control group (CG) (n = 109). Intervention consisted of 16 lectures by experts, eight group discussions, six group exercise sessions, and three social activity events.


RESULTS
The use of lipid-lowering medications became more common in IG than in CG among men (p = 0.041), with a similar tendency among women. Among women, decreases in the means of total serum cholesterol (p = 0.009) and LDL-cholesterol (p = 0.049) were greater in IG than in CG.


CONCLUSIONS
The program produced no positive effects on health behavior. Positive effects were gained by the increase in lipid-lowering medications, which reduced mean total serum cholesterol and LDL-cholesterol concentrations. More intensive counseling on health behavior should be planned, implemented, and evaluated.
Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland. majosa@utu.fi
Marika
M
Salminen
Raimo
R
Isoaho
Tero
T
Vahlberg
Ansa
A
Ojanlatva
Kerttu
K
Irjala
Sirkka-Liisa
SL
Kivelä
D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D003376:Counseling / Q000458:organization & administration / Q000706:statistics & numerical data*; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D015438:Health Behavior; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D008137:Longitudinal Studies; D008297:Male; D010344:Patient Advocacy / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012907:Smoking / Q000453:epidemiology
D000924:Anticholesteremic Agents; D002784:Cholesterol