Guideline-based early rehabilitation after myocardial infarction. A pragmatic randomised controlled trial |
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Authors: | Mayou Richard A Thompson David R Clements Alison Davies Crispin H Goodwin Sarah J Normington Kathryn Hicks Nicholas Price Jonathan |
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Institution: | Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, Oxford, UK. richard.mayou@psych.ox.ac.uk |
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Abstract: | OBJECTIVES: To determine the effectiveness of individualised educational behavioural treatment delivered by cardiac nurses in hospital compared to usual care for patients following acute myocardial infarction. METHODS: One hundred and fourteen consecutive patients were randomised to receive the intervention or usual care. Outcome assessment was by self-report questionnaire (the Hospital Anxiety and Depression Scale and Dartmouth COOP Health Status), interview at 1 month, and self-report at 3 and 12 months. The primary outcome was improvement in the Dartmouth COOP total score from baseline to 3 months. RESULTS: Four patients needed to be treated to give an additional patient with improvement in health status at 3 months (number needed to treat NNT] 4, 95% confidence intervals CIs] 3 to 12). The intervention group were more confident about returning to activities 1 month after discharge from hospital. Treated patients had fewer further treatment needs. CONCLUSIONS: An individualised educational behavioural treatment delivered by cardiac nurses in hospital may have substantial benefits. A large-scale pragmatic RCT is needed. |
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Keywords: | Cardiac rehabilitation Heart Myocardial infarction Psychological Randomised controlled trial |
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