The COACH program produces sustained improvements in cardiovascular risk factors and adherence to recommended medications-two years follow-up.
OBJECTIVE
To assess whether The COACH Program could sustain its favourable impact on coronary risk factors (CRFs) and adherence to recommended medication for 18 months after the completion of The COACH Program.


METHODS
A clinical audit of a secondary prevention program performed in three teaching hospitals in Melbourne, Victoria for patients with coronary heart disease (CHD). The CRF targets were based on recommendations from the National Heart Foundation of Australia between 2003 and 2007.


RESULTS
656 patients were followed by telephone every 6 months from recruitment in hospital for 2 years. There was a substantial improvement in all CRF from discharge from hospital to the completion of active coaching 6 months after hospital discharge. There was also a significant increase in the proportion of patients taking statins and renin-angiotensin system antagonists in the same period of time. There was a small deterioration in CRF status in the 6 months after exit from The COACH Program but thereafter CRF status was maintained and substantially better than that on entry to The COACH Program. The use of the recommended cardio-protective medications remained at the levels achieved at exit from The COACH Program.


CONCLUSIONS
The changes in CRF status and adherence to cardiac medications achieved at 6 months in The COACH Program are sustained for at least 18 months after cessation of The COACH Program.
Jelinek
Michael
M
Department of Medicine, The University of Melbourne, Australia. michael.jelinek@svhm.org.au
Vale
Margarite J
MJ
Liew
Danny
D
Grigg
Leeanne
L
Dart
Anthony
A
Hare
David L
DL
Best
James D
JD
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001315:Australia; D003324:Coronary Artery Disease / Q000517:prevention & control*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D013997:Time Factors; D055815:Young Adult; D016903:Drug Monitoring
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors