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Keywords:

  • angina nurses;
  • cardiac rehabilitation;
  • lay-led care;
  • randomized controlled trial;
  • self-management;
  • stable angina

furze g., cox h., morton v., chuang l.-h., lewin r.j.p., nelson p., carty r., norris h., patel n. & elton p. (2012) Randomized controlled trial of a lay-facilitated angina management programme. Journal of Advanced Nursing68(10), 2267–2279.

Abstract

Aims.  This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP).

Background.  Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes.

Design.  A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist.

Methods.  Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6 months; secondary outcomes at 3 and 6 months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation.

Results.  There was no important difference in angina frequency at 6 months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3 months for: Anxiety, angina misconceptions and for exercise report; and at 6 months for: Anxiety; Depression; and angina misconceptions. The intervention was considered cost-effective.

Conclusion.  The angina management programme produced some superior benefits when compared to advice from a specialist nurse.