A randomised controlled trial to evaluate a nurse-led programme of support and lifestyle management for patients awaiting cardiac surgery 'Fit for surgery: Fit for life' study.
BACKGROUND
The 'Fit For Surgery' programme was based on previous studies suggesting improvement in risk factors contributing to coronary disease while patients wait for cardiac surgery.


OBJECTIVE
To evaluate our nurse-led programme in a randomised controlled trial with 188 patients.


METHODS
Patients listed for coronary artery bypass surgery with at least one poorly controlled risk factor were randomised to standard care or the intervention which provided lifestyle counselling and preparation for surgery at monthly intervals. Primary outcome measurements were anxiety, blood pressure, cholesterol, length of stay and body mass index. Costs of the intervention were also collected.


RESULTS
For both groups blood pressure and total cholesterol improved (Blood pressure mm Hg (Control -9.11 (CI -4.89, -13.33); Intervention -13.02 (CI -8.76, -U17.29) both p<0.01); total cholesterol (Control -0.20 (CI -0.03, -0.37) p=0.02, Intervention -0.18 (CI -0.02, -0.34) p=0.03). However there were no significant differences between the groups. Cost minimization analysis showed that the total costs were less in the intervention group due to fewer admissions (total costs pounds 10,754 (3746) v pounds 13,047 (5835), CI -3743, -843; p=0.002).


CONCLUSIONS
The nurse-led programme did not appear to reduce risk factors prior to coronary artery bypass surgery. However, the intervention appears to reduce overall healthcare utilization.
Goodman
Helen
H
Health Services Research Unit, Clinical Cardiology, Imperial College, London, UK. H.Goodman@rbht.nhs.uk
Parsons
Amanda
A
Davison
June
J
Preedy
Michael
M
Peters
Emma
E
Shuldham
Caroline
C
Pepper
John
J
Cowie
Martin R
MR
D001026:Coronary Artery Bypass / Q000191:economics / Q000451:nursing*; D003327:Coronary Disease / Q000191:economics / Q000451:nursing* / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011300:Preoperative Care / Q000191:economics; D015397:Program Evaluation; D011788:Quality of Life; D012307:Risk Factors; D012944:Social Support; D006113:United Kingdom; D014850:Waiting Lists