Effects of intervention on lifestyle changes among coronary artery disease patients: A 6-month follow-up study.

All lifestyle outcomes were self-reported, so social desirability or recall bias may have affected them. Randomisation was not matched, and medication adherence differed at baseline, so the groups were not identical on that variable. There was no double blinding, and the nurse investigator who delivered the intervention also collected data, which could have favoured the intervention group. Possible contamination between groups was acknowledged, although counselling was given at discharge to reduce it. Follow-up data were collected by telephone rather than face-to-face. The study was done at a single cardiac centre in Nepal, so generalisability is limited. Of 224 enrolled patients, 184 were analysed at 6 months. The paper assessed multiple lifestyle risk factors and did not identify a single primary outcome, so some significant differences may reflect multiple comparisons.

The authors declare no conflict of interest. The study was funded by Pirkanmaan Rahasto.

Do not conclude that nurse counselling alone caused the lifestyle changes. Usual care also included brief unstructured counselling, the intervention components were delivered together, outcomes were self-reported, and medication adherence differed at baseline.