Achievement of secondary preventive goals after acute myocardial infarction: a comparison between participants and nonparticipants in a routine patient education program in Sweden.
BACKGROUND
Modification of risk factors such as smoking, obesity, physical inactivity, and hypertension after acute myocardial infarction (AMI) has been shown to reduce mortality and morbidity. Therefore, most hospitals in Sweden invite patients with myocardial infarction to an educational program, the "Heart School," where they can learn about lifestyle changes. Whether this kind of education program applied in routine care increases the proportion of patients achieving secondary prevention goals is unknown.


METHODS
A cohort of consecutive patients treated for AMI and included in a quality registry was followed up during 1 year. The main aim was to study the effects of taking part in the Heart School on smoking habits, blood pressure and low-density lipoprotein cholesterol levels, exercise habits, cardiac symptoms, quality of life, and readmissions to hospital. Patients included in the national quality register of secondary prevention after AMI who had participated in the educational program were compared with those who had not participated in the program. Achievements of secondary prevention goals 1 year after the myocardial infarction were evaluated. The study included 2,822 patients.


RESULTS
The result showed that patients who participated in the Heart School stopped smoking more often than those who did not participate (adjusted odds ratio, 2.01; 95% confidence interval, 1.46-2.78). The Heart School had no effects on the other variables that were examined.


CONCLUSIONS
The interventions currently used in the Swedish Heart School seem to be insufficient to obtain sustainable lifestyle changes, except for smoking cessation.
Bellman
Christina
C
Department of Medicine, South Hospital, Stockholm, Sweden. Christina.bellman@sodersjukhuset.se
Hambraeus
Kristina
K
Lindbäck
Johan
J
Lindahl
Bertil
B
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000534:rehabilitation*; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D010359:Patient Readmission / Q000706:statistics & numerical data; D015397:Program Evaluation; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000458:organization & administration*; D012907:Smoking / Q000009:adverse effects; D000074606:Smoking Prevention; D018709:Statistics, Nonparametric; D013548:Sweden