title: Community-based comprehensive lifestyle programs in patients with coronary artery disease: Objectives, design and expected results of Randomized Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists 2 trial (RESPONSE 2).
abstract: Patients with coronary artery disease (CAD) are at high risk of recurrent events. A healthy lifestyle can significantly reduce this risk. A previous trial, Randomized Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists (RESPONSE), demonstrated that nurse-coordinated outpatient clinics improve drug treatment of cardiovascular risk factors. However, lifestyle-related risk factors, including smoking, overweight, and physical inactivity, were common and remained largely unchanged at follow-up in most patients (66%). The aim of the current study is to evaluate the impact of 3 community-based lifestyle programs in patients after hospitalization for CAD. We are conducting a multicenter (n = 15), randomized trial that will recruit 800 patients to test the efficacy of up to 3 widely available commercial lifestyle programs, aimed at patients and their partners, on top of usual care. These programs are aimed at smoking cessation (Luchtsignaal(®)), weight loss (Weight Watchers(®)), and improving physical activity (Philips DirectLife(®)).
  
  
  RESULTS
  The primary outcome at 12months is the proportion of patients in whom at least 1 lifestyle risk factor is improved without deterioration in any of the other 2, and a relative increase of at least 30% in this proportion is considered clinically relevant.
authors: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Sangeeta
authors: S
authors: Lachman
authors: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Madelon
authors: M
authors: Minneboo
authors: Amsterdam University of Applied Sciences, School of Health Professions, Amsterdam, the Netherlands.
authors: Marjolein
authors: M
authors: Snaterse
authors: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Harald T
authors: HT
authors: Jorstad
authors: Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
authors: Gerben
authors: G
authors: Ter Riet
authors: Amsterdam University of Applied Sciences, School of Health Professions, Amsterdam, the Netherlands.
authors: Wilma J
authors: WJ
authors: Scholte Op Reimer
authors: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors: S Matthijs
authors: SM
authors: Boekholdt
authors: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: r.j.peters@amc.nl.
authors: Ron J G
authors: RJ
authors: Peters
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000451:nursing* / Q000517:prevention & control; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015397:Program Evaluation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*