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A randomised controlled trial of a self-management plan for patients with newly diagnosed angina

Lewin, R.J.P., Furze, G., Robinson, J., Griffith, K., Wiseman, S., Pye, M. and Boyle, R. (2002) A randomised controlled trial of a self-management plan for patients with newly diagnosed angina. British Journal of General Practice, 52 (476). pp. 194-201. ISSN 0960-1643

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Abstract

BACKGROUND:

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. AIM: To evaluate the effect of a cognitive behavioural disease management programme, the Angina Plan, on psychological adjustment in patients newly diagnosed with angina pectoris.

DESIGN OF STUDY: Randomised controlled trial.

SETTING: Patients from GP practices in a Northern UK city (York) between April 1999 and May 2000.

METHOD: Recruited patients were randomised to receive the Angina Plan or to a routine, practice nurse-led secondary prevention educational session.

RESULTS: 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 six 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.

CONCLUSION: The Angina Plan appears to improve the psychological, symptomatic, and functional status of patients newly diagnosed with angina.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 03 Sep 2009 14:19
Last Modified: 03 Sep 2009 14:19
Status: Published
Publisher: Royal College of General Practitioners
URI: http://eprints.whiterose.ac.uk/id/eprint/5785

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