NURSE CASE MANAGEMENT SYSTEM FOR LIPID MANAGEMENT AFTER CORONARY BYPASS SURGERY

用于冠状动脉搭桥手术后脂质管理的护士案例管理系统

• 批准号: 6218301
• 负责人: JERILYN K ALLEN
• 金额: $ 0.23万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6218301
• 关键词: antihypercholesterolemic agent; behavior modification; behavioral /social science research tag; clinical research; coronary bypass; disease /disorder prevention /control; health services research tag; human morbidity; human mortality; human subject; lifestyle; lipid disorder; low density lipoprotein; nursing intervention; patient care management; posthospitalization care; quality of life

The purpose of this study is to evaluate the effectiveness of a nurse-managed, case-management system of individualized lifestyle modification and pharmacologic intervention to manage lipid disorders in adults who have undergone coronary artery bypass graft surgery (CABG). Clinical trials have provided strong scientific evidence that lowering serum cholesterol will reduce morbidity and mortality from coronary heart disease (CHD) in patients with established CHD.1 Despite the clear benefits of cholesterol-lowering treatment, many patients with clinical evidence of atherosclerosis are not being treated effectively.2-4 Changes in the delivery of health care, including care for and after coronary events, mandate that we consider more effective and economical strategies for the management of lipid disorders in those with CHD so that the benefits of lipid lowering can be achieved outside of clinical drug trials. The primary aims of this study are to: 1. compare the effectiveness of a nurse-managed program for lipid modification with that of usual medical care in dyslipidemic adults who have undergone CABG in achieving the goal of a LDL-cholesterol < 100 mg/dL or a > 20% reduction in LDL-cholesterol; 2. determine the physiologic, behavioral, and demographic predictors of goal attainment; 3. determine the cost effectiveness of a nurse-managed lipid-lowering program; and 4. assess the impact of lipid-lowering therapy on patients quality of life. Our goal is to optimize lifestyle modification, thereby minimizing and improving the efficacy of pharmacologic intervention. We hypothesize that a significantly higher proportion of those who participate in the nurse-managed program for lipid modification will attain the goal for lipid lowering compared to those who receive usual care from their primary providers. Additionally, we propose that the intervention is a cost-effective model of delivering lipid-lowering therapy that lends itself to widespread application.

本研究的目的是评估护士管理的个体化生活方式调整和药物干预的病例管理系统对接受冠状动脉旁路移植术（CABG）的成人血脂紊乱的有效性。临床试验提供了强有力的科学证据，表明降低血清胆固醇将降低冠心病（CHD）患者的发病率和死亡率。1尽管降胆固醇治疗有明显的益处，但许多有动脉粥样硬化临床证据的患者并未得到有效治疗。2 -4医疗保健提供的变化，包括冠状动脉事件发生时和发生后的护理，要求我们考虑更有效和经济的策略来管理CHD患者的血脂紊乱，以便在临床药物试验之外实现降脂的益处。 本研究的主要目的是：1。 比较在经历CABG的血脂异常成年人中，在实现LDL-胆固醇< 100 mg/dL或LDL-胆固醇降低> 20%的目标方面，护士管理的脂质调节计划与常规医疗护理的有效性; 2. 确定目标达成的生理、行为和人口统计学预测因素; 3. 确定护士管理的降脂计划的成本效益;和4. 评估降脂治疗对患者生活质量的影响。 我们的目标是优化生活方式的改变，从而最大限度地减少和提高药物干预的疗效。 我们假设，一个显着更高比例的那些谁参加了护士管理的计划，脂质修改将达到降脂的目标相比，那些谁从他们的主要提供者接受常规护理。 此外，我们建议，干预是一个具有成本效益的模型，提供降脂治疗，适合广泛应用。