Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction.
Ángel Lizcano-Álvarez, Laura Carretero-Julián, Ana Talavera-Saez and 3 others
PMID 37084014WHAT IT FOUND
Diet, activity, and medication adherence scores rose after nurse-led primary care follow-up in patients with myocardial infarction or ischaemic heart disease, but self-management dimensions changed variably and there was no control group.
Key findings
01After follow-up, outcome scores for diet, activity, and medication adherence rose by 0.45 points, 0.33 points, and 0.76 points on a 1-5 scale.
02The self-management outcome had six dimensions, with mean changes reported from 0.25 to 0.9 points and some dimensions showing negative mean changes.
03132 of 209 patients completed the follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was no control group, so the score changes cannot be separated from usual care, time, or other treatments given together. The study began with 209 patients and ended with 132, so the analysed group may differ from those who dropped out. Nurses volunteered, and patients were selected purposively, which could create selection bias. Neither nurses nor patients were blinded to the intervention. The medication adherence scale had a reliability score of 0.683, below the study's stated optimal threshold of 0.7. The selected nursing outcome indicators were pending validation for accuracy, significance, and utility. The intervention included protocolised consultations, a notebook, education, home self-recording, and family engagement, so the contribution of any single component cannot be separated.
Declared interests
The study received a national nursing research prize from the Gregorio Marañón General University Hospital in Madrid in 2017, and the named funder was Instituto de Investigación Sanitaria Gregorio Marañón. The authors declared no conflicts of interest.
The easy way to misread this
Do not read the score increases as proof that nurse-led follow-up works. The study had no control group, and patients also received routine primary care, a self-care notebook, education, home self-recording, and family engagement, so the effect of any single component cannot be separated.