title: Evaluation of a postdischarge coronary artery disease management program.
abstract: OBJECTIVE
  We conducted a demonstration project to assess the value of a nurse practitioner (NP) based coronary artery disease management (CAD-DM) program for patients with an acute coronary syndrome (ACS) or percutaneous coronary intervention.
  
  
  METHODS
  Patients were recruited to attend three 1-h monthly visits. The intervention included assessment of clinical symptoms and guideline-based treatments; education regarding CAD/ACS; review of nutrition, exercise, and appropriate referrals; and recognition of significant symptoms and emergency response.
  
  
  RESULTS
  Two hundred thirteen (84.5%) completed the program. Physician approval for patient participation was 99%. Average age was 63 ± 11 years, 70% were male, and 89% white. At baseline, 61% (n = 133) had one or more cardiopulmonary symptoms, which declined to 30% at 12 weeks, p < .001. Sixty-nine percent attended cardiac rehabilitation or an exercise consult. Compared to the initial assessment, an additional 20% were at low-density lipoprotein cholesterol < 70 mg/dL (p = .04), an additional 35% met exercise goals (p < .0001), and there was an improvement in the mental (baseline 49.7 vs. 12 weeks 53, p = .0015) and physical components (44 vs. 48, p = .002) of the SF-12 health survey.
  
  
  CONCLUSIONS
  This NP-based CAD-DM program was well received and participants demonstrated improvement in physical and mental health, and increased compliance with recommended lifestyle changes.
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Housholder-Hughes
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ranella
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York, New York.
authors.forename: Abiola
authors.initials: A
authors.lastname: Dele-Michael
authors.affiliation: College of Health and Human Services, Eastern Michigan University, Ypsilanti, Michigan
authors.forename: Sherry
authors.initials: S
authors.lastname: Bumpus
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Sangeetha M
authors.initials: SM
authors.lastname: Krishnan
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Melvyn
authors.initials: M
authors.lastname: Rubenfire
mesh_terms: D019985:Benchmarking; D003324:Coronary Artery Disease / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009722:Nurse Practitioners; D010349:Patient Compliance; D010351:Patient Discharge; D057184:Practice Patterns, Nurses'; D011788:Quality of Life
keywords: Disease management; acute coronary syndrome; nurse practitioner