TY - JOUR
T1 - Community-Based Lifestyle Intervention in Patients With Coronary Artery Disease: The RESPONSE-2 Trial
AU - Minneboo, Madelon
AU - Lachman, Sangeeta
AU - Snaterse, Marjolein
AU - Jørstad, Harald T.
AU - ter Riet, Gerben
AU - Boekholdt, S. Matthijs
AU - Scholte op Reimer, Wilma J. M.
AU - Peters, Ron J. G.
AU - AUTHOR GROUP
AU - Riezebos, R. K.
AU - van Liebergen, R. A. M.
AU - van der Spank, A.
AU - van Dantzig, J. M.
AU - de Milliano, P. A. R.
AU - van Hessen, M. W. J.
AU - Kragten, J. A.
AU - Jaarsma, W.
AU - den Hartog, F. R.
AU - Bartels, G. L.
AU - Aengevaeren, W. R. M.
AU - van Rossum, P.
AU - Anneveldt, A.
AU - de Vries, C. J.
PY - 2017
Y1 - 2017
N2 - Among patients with coronary artery disease (CAD), improvement of lifestyle-related risk factors (LRFs) reduces cardiovascular morbidity and mortality. However, modification of LRFs is highly challenging. This study sought to evaluate the impact of combining community-based lifestyle programs with regular hospital-based secondary prevention. The authors performed a randomized controlled trial of nurse-coordinated referral of patients and their partners to 3 widely available community-based lifestyle programs, in 15 hospitals in the Netherlands. Patients admitted for acute coronary syndrome and/or revascularization, with ≥1 LRF (body mass index >27 kg/m(2), self-reported physical inactivity, and/or smoking) were included. All patients received guideline-based usual care. The intervention was based on 3 lifestyle programs for weight reduction, increasing physical activity, and smoking cessation. The primary outcome was the proportion of success at 12 months, defined as improvement in ≥1 qualifying LRF using weight (≥5% reduction), 6-min-walking distance (≥10% improvement), and urinary cotinine (200 ng/ml detection limit) without deterioration in the other 2. The authors randomized 824 patients. Complete data on the primary outcome were available in 711 patients. The proportion of successful patients in the intervention group was 37% (133 of 360) compared with 26% (91 of 351) in the control group (p = 0.002; risk ratio: 1.43; 95% confidence interval: 1.14 to 1.78). In the intervention group, partner participation was associated with a significantly greater success rate (46% vs. 34%; p = 0.03). Among patients with coronary artery disease, nurse-coordinated referral to a comprehensive set of community-based, widely available lifestyle interventions, with optional partner participation, leads to significant improvements in LRFs. (RESPONSE-2: Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists 2; NTR3937)
AB - Among patients with coronary artery disease (CAD), improvement of lifestyle-related risk factors (LRFs) reduces cardiovascular morbidity and mortality. However, modification of LRFs is highly challenging. This study sought to evaluate the impact of combining community-based lifestyle programs with regular hospital-based secondary prevention. The authors performed a randomized controlled trial of nurse-coordinated referral of patients and their partners to 3 widely available community-based lifestyle programs, in 15 hospitals in the Netherlands. Patients admitted for acute coronary syndrome and/or revascularization, with ≥1 LRF (body mass index >27 kg/m(2), self-reported physical inactivity, and/or smoking) were included. All patients received guideline-based usual care. The intervention was based on 3 lifestyle programs for weight reduction, increasing physical activity, and smoking cessation. The primary outcome was the proportion of success at 12 months, defined as improvement in ≥1 qualifying LRF using weight (≥5% reduction), 6-min-walking distance (≥10% improvement), and urinary cotinine (200 ng/ml detection limit) without deterioration in the other 2. The authors randomized 824 patients. Complete data on the primary outcome were available in 711 patients. The proportion of successful patients in the intervention group was 37% (133 of 360) compared with 26% (91 of 351) in the control group (p = 0.002; risk ratio: 1.43; 95% confidence interval: 1.14 to 1.78). In the intervention group, partner participation was associated with a significantly greater success rate (46% vs. 34%; p = 0.03). Among patients with coronary artery disease, nurse-coordinated referral to a comprehensive set of community-based, widely available lifestyle interventions, with optional partner participation, leads to significant improvements in LRFs. (RESPONSE-2: Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists 2; NTR3937)
U2 - https://doi.org/10.1016/j.jacc.2017.05.041
DO - https://doi.org/10.1016/j.jacc.2017.05.041
M3 - Article
C2 - 28705312
SN - 0735-1097
VL - 70
SP - 318
EP - 327
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 3
ER -