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Nurse-Led, Telephone-Based, Secondary Preventive Follow-Up after Stroke or Transient Ischemic Attack Improves Blood Pressure and LDL Cholesterol : Results from the First 12 Months of the Randomized, Controlled NAILED Stroke Risk Factor Trial

Irewall, Anna-Lotta, 1987- (författare)
Umeå universitet,Medicin,Östersunds sjukhus
Ögren, Joachim (författare)
Umeå universitet,Medicin,Department of Public Health and Clinical Medicine, Östersund, Sweden,Research Unit Östersund
Bergström, Lisa (författare)
Umeå universitet,Medicin,Department of Public Health and Clinical Medicine, Östersund, Sweden,Research Unit Östersund
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Laurell, Katarina (författare)
Umeå universitet,Klinisk neurovetenskap,Östersunds sjukhus
Söderström, Lars (författare)
Unit of Research, Development and Education, Region Jämtland Härjedalen, Östersund Hospital, Östersund, Sweden
Mooe, Thomas (författare)
Umeå universitet,Medicin,Research Unit Östersund
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 (creator_code:org_t)
2015-10-16
2015
Engelska.
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:10
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Enhanced secondary preventive follow-up after stroke or transient ischemic attack (TIA) is necessary for improved adherence to recommendations regarding blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels. We investigated whether nurse-led, telephone-based follow-up was more efficient than usual care at improving BP and LDL-C levels at 12 months after hospital discharge.Methods: We randomized 537 patients to either nurse-led, telephone-based follow-up (intervention) or usual care (control). BP and LDL-C measurements were performed at 1 month (baseline) and 12 months post-discharge. Intervention group patients who did not meet target values at baseline received additional follow-up, including titration of medication and lifestyle counselling, to reach treatment goals (BP < 140/90 mmHg, LDL-C < 2.5 mmol/L).Results: At 12 months, mean systolic BP, diastolic BP and LDL-C was 3.3 (95% CI 0.3 to 6.3) mmHg, 2.3 mmHg (95% CI 0.5 to 4.2) and 0.3 mmol/L (95% CI 0.1 to 0.4) lower in the intervention group compared to controls. Among participants with values above the treatment goal at baseline, the difference in systolic BP and LDL-C was more pronounced (8.0 mmHg, 95% CI 4.0 to 12.1, and 0.6 mmol/L, 95% CI 0.4 to 0.9). A larger proportion of the intervention group reached the treatment goal for systolic BP (68.5 vs. 56.8%, p = 0.008) and LDL-C (69.7% vs. 50.4%, p < 0.001).Conclusions: Nurse-led, telephone-based secondary preventive follow-up, including medication adjustment, was significantly more efficient than usual care at improving BP and LDL-C levels by 12 months post-discharge.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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