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Evidence
Lewin RJP, Furze G, Robinson J, Griffith K, Wiseman S, Pye M, Boyle R.
A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
British Journal of General Practice 2002;52:194-201 |
Background:
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There are approximately 1.8 million patients with angina in the United Kingdom, many of whom report a poor quality of life, including raised levels of anxiety and depression.
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Aim:
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To evaluate the effect of a cognitive behavioural disease management programme, the Angina Plan, on psychological adjustment in patients newly diagnosed with angina pectoris.
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Design of Study:
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Randomised controlled trial.
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Setting:
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Patients were recruited from GP practices in a Northern UK city (York) between April 1999 and May 2000.
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Method:
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Recruited patients were randomised to receive the Angina Plan or to a routine, practice nurse-led, secondary prevention educational session.
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Results:
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Twenty of the 25 practices invited to join the study supplied patients' names; 142 patients attended an assessment clinic and were randomised. There were no significant differences in any baseline measures. At the 6 month post-treatment follow-up, 130 (91%) patients were reassessed. When compared with the educational session patients (using analysis of covariance adjusted for baseline scores in an intention-to-treat analysis) Angina Plan patients showed a greater reduction in; anxiety (P=0.05) and depression (P = 0.01), the frequency of angina (reduced by three episodes per week, versus a reduction of 0.4 per week, P=0.016) the use of glyceryl trinitrate (reduced by 4.19 fewer doses per week versus a reduction of 0.59 per week, P=0.018), and physical limitations (P<0.001:Seattle Angina Questionnaire). They were also more likely to report having changed their diet (41 versus 21, P<0.001) and increased their daily walking (30 versus 2, P<0.001). There was no significant difference between the groups on the other sub-scales of the Seattle Angina Questionnaire or in any of the medical variables measured.
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Conclusions:
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The Angina Plan appears to improve the psychological, symptomatic and functional status of patients newly diagnosed with angina.
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© British Journal of General Practice 2002;52:194-201
rcgp.org.uk
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