The COACH Program Produces Sustained Improvements in Cardiovascular Risk Factors and Adherence to Recommended Medications—Two Years Follow-up

Jelinek, Michael; Vale, Margarite J.; Liew, Danny; Grigg, Leeanne; Dart, Anthony; Hare, David L.; Best, James D.

doi:10.1016/j.hlc.2009.06.001

« Previous Next »Heart, Lung and Circulation
Volume 18, Issue 6 , Pages 388-392, December 2009

The COACH Program Produces Sustained Improvements in Cardiovascular Risk Factors and Adherence to Recommended Medications—Two Years Follow-up

Michael Jelinek, MD
- Department of Medicine, The University of Melbourne, Australia
- St.Vincent's Hospital, Melbourne, Australia
- Corresponding author at: 55 Victoria Parade, Fitzroy 3065, Victoria, Australia. Tel.: +61 394170177; fax: +61 394170180.
Margarite J. Vale, PhD
- Department of Medicine, The University of Melbourne, Australia
- St.Vincent's Hospital, Melbourne, Australia
Danny Liew, MBBS
- Department of Medicine, The University of Melbourne, Australia
- St.Vincent's Hospital, Melbourne, Australia
Leeanne Grigg, MBBS
- The Royal Melbourne Hospital, Australia
Anthony Dart, BA BM BCh FRCP Dphil
- Alfred Hospital, Australia
David L. Hare, MBBS
- Department of Medicine, The University of Melbourne, Australia
- Austin and Repatriation Medical Centre, Australia
James D. Best, MD
- Department of Medicine, The University of Melbourne, Australia
- St.Vincent's Hospital, Melbourne, Australia

Received 25 March 2009; received in revised form 22 May 2009; accepted 5 June 2009.

Purpose

To assess whether The COACH Program could sustain its favourable impact on coronary risk factors (CRFs) and adherence to recommended medication for 18 months after the completion of The COACH Program.

Method

A clinical audit of a secondary prevention program performed in three teaching hospitals in Melbourne, Victoria for patients with coronary heart disease (CHD). The CRF targets were based on recommendations from the National Heart Foundation of Australia between 2003 and 2007.

Results

656 patients were followed by telephone every 6 months from recruitment in hospital for 2 years. There was a substantial improvement in all CRF from discharge from hospital to the completion of active coaching 6 months after hospital discharge. There was also a significant increase in the proportion of patients taking statins and renin–angiotensin system antagonists in the same period of time. There was a small deterioration in CRF status in the 6 months after exit from The COACH Program but thereafter CRF status was maintained and substantially better than that on entry to The COACH Program. The use of the recommended cardio-protective medications remained at the levels achieved at exit from The COACH Program.

Conclusion

The changes in CRF status and adherence to cardiac medications achieved at 6 months in The COACH Program are sustained for at least 18 months after cessation of The COACH Program.

Keywords: Secondary prevention, Coronary disease, Health services administration