title: A randomised controlled trial of lay-led self-management for myocardial infarction patients who have completed cardiac rehabilitation.
abstract: BACKGROUND
  There are increasing opportunities for MI patients to attend lay-led, community based generic self-management programmes via self-referral.
  
  
  OBJECTIVE
  To determine the effectiveness of the Expert Patient Programme (EPP) for MI patients who had completed CR using a randomised controlled, wait-list design, with a nested qualitative study.
  
  
  METHODS
  The Intervention Group attends the EPP immediately after completing the baseline assessment; The Control Group had the opportunity to attend the EPP after completion of the 4-month follow-up. 192 MI patients (72% men) completed baseline assessment; 162 responded at follow-up. Telephone interviews were conducted with 10 male and 9 female Intervention group participants.
  
  
  RESULTS
  Intention-to-treat analysis revealed no statistically significant differences between the groups although a pattern of small improvements among the Intervention Group was observed over time. Interviews revealed that Intervention Group participants viewed CR as being more about instruction whereas the EPP was viewed as being more about discussion, mutual support, and goal setting. A gender difference emerged whereby male participants valued information exchange whereas female participants expressed a preference for emotional support and social interaction within the EPP context.
  
  
  CONCLUSIONS
  The EPP appears to hold few benefits for MI patients who have attended CR.
authors.affiliation: Self-management Programme, Applied Research Centre in Health and Lifestyle Interventions, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK. j.barlow@coventry.ac.uk
authors.forename: J H
authors.initials: JH
authors.lastname: Barlow
authors.forename: A P
authors.initials: AP
authors.lastname: Turner
authors.forename: M
authors.initials: M
authors.lastname: Gilchrist
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation*; D057240:Patient Preference; D010379:Peer Group; D015397:Program Evaluation; D036301:Qualitative Research; D019145:Rehabilitation Nursing / Q000379:methods; D012648:Self Care / Q000379:methods*; D012944:Social Support; D011795:Surveys and Questionnaires