NURSE CASE MANAGEMENT SYSTEM FOR LIPID MANAGEMENT AFTER CORONARY BYPASS SURGERY

本研究的目的是评估护士的有效性- 个体化生活方式改变的管理、个案管理系统 和药物干预，以管理成人血脂紊乱， 冠状动脉旁路移植术（CABG）。 临床 试验提供了强有力的科学证据， 胆固醇将降低冠心病的发病率和死亡率 冠心病（CHD）患者中确诊CHD。 尽管显然 降低胆固醇治疗的好处，许多患者的临床 动脉粥样硬化的证据没有得到有效的治疗。 变化 在提供保健方面，包括冠心病和冠心病后的保健 我们认为更有效和更经济的任务 冠心病患者血脂紊乱的管理策略， 降脂的益处可以在临床之外实现， 药物试验 本研究的主要目的是：1。比较 护士管理的脂质修饰计划的有效性 在经历过血脂异常的成年人中， CABG在实现LDL-胆固醇<100 mg/dL或> 20%的目标中的作用 降低LDL-胆固醇; 2.确定生理的，行为的， 和目标实现的人口预测因素; 3.确定成本 护士管理的降脂计划的有效性;和4.评估 降脂治疗对患者生活质量的影响。 我们 目标是优化生活方式的改变，从而最大限度地减少和 提高药物干预的有效性。 我们假设 参与研究的人中， 护士管理的脂质修饰计划将达到目标， 与那些接受常规护理的人相比， 主要供应商。 此外，我们建议干预是 一种成本效益高的降脂治疗模式， 自身的广泛应用。

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. Despite the clear benefits of cholesterol-lowering treatment, many patients with clinical evidence of atherosclerosis are not being treated effectively. 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 < I 00 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.