The proposed study is a randomized clinical trial of behavioral interventions to modify dietary, exercise, and smoking behaviors as well as pharmacologic treatment delivered by a nurse case manager compared with usual care administered by primary care providers in the traditional medical system. Two hundred forty CABG patients who meet eligibility criteria will be randomly assigned to the nursing intervention group or the usual care group and followed for outcome evaluation at 6, 12, and 24 months. The major outcomes will be 1) achievement of nationally recognized goal levels of LDL-cholesterol, 2) impact of cholesterol-lowering therapy on quality of life, and 3) cost-effectiveness of the lipid-lowering program. Statistical analysis will focus on the proportion in each group who achieve goal at the follow-up periods. Survival analysis will be used to examine the effect of the intervention on the timing of patients reaching goal levels. In addition, multiple logistic regression analysis will be performed to determine the best set of predictors of risk factor goal attainment in the overall group. Quality of life by study group over time will be examined using MANOVA. Comparisons of the cost per percentage decrease in LDL-cholesterol between the nurse-managed and usual care groups will be analyzed with cost-effectiveness ratios.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
1R01NR004432-01
Application #
2036147
Study Section
Nursing Research Study Section (NURS)
Program Officer
Sigmon, Hilary D
Project Start
1997-06-01
Project End
2001-02-28
Budget Start
1997-06-01
Budget End
1998-02-28
Support Year
1
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Type
Schools of Nursing
DUNS #
045911138
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Miller 3rd, Edgar R; Erlinger, Thomas P; Blumenthal, Roger S et al. (2003) Antibodies to oxidized low-density lipoprotein in patients following coronary artery revascularization. Coron Artery Dis 14:163-9