Reversing social disadvantage in secondary prevention of coronary heart disease

Jelinek, Michael V., Santamaria, John D., Best, James D., Thompson, David R., Tonkin, Andrew M. and Vale, Margarite J. (2013) Reversing social disadvantage in secondary prevention of coronary heart disease. International Journal of Cardiology, 171 3: 346-350. doi:10.1016/j.ijcard.2013.12.022

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Author Jelinek, Michael V.
Santamaria, John D.
Best, James D.
Thompson, David R.
Tonkin, Andrew M.
Vale, Margarite J.
Title Reversing social disadvantage in secondary prevention of coronary heart disease
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
Publication date 2013-12-24
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2013.12.022
Open Access Status Not Open Access
Volume 171
Issue 3
Start page 346
End page 350
Total pages 5
Place of publication Clare, Ireland
Publisher Elsevier
Language eng
Formatted abstract
Background: To compare and contrast the coronary heart disease (CHD) risk factors of lower socio-economic status public hospital patients with those of privately insured CHD patients before and after six months of telephone delivered coaching using The COACH Program.

Methods: A retrospective observational study which contrasts the lifestyle and biomedical coronary risk factor status of 2256 public hospital patients with the same risk factors of 3278 patients who had private health insurance. All patients received an average of 5 coach sessions over 6 months.

Results: The public hospital patients were four years younger and had multiple measures confirming their lower socio-economic status than their private hospital counterparts. At entry to the program, the public hospital patients had worse risk factor levels than the privately insured patients for total and LDL-cholesterol, triglycerides, fasting glucose, smoking and physical activity levels (P < 0.0001) but better status for systolic and diastolic blood pressures and alcohol intake. At exit from the program, many of these differences had diminished or disappeared. The public hospital patients had greater improvements in their risk factor status for total and LDL-cholesterol, fasting glucose, body weight, smoking status and physical activity level than did the privately insured patients (P < 0.05).

Conclusions: This paper demonstrates that a program of initiating contact with patients with CHD, identifying treatment gaps in their management and coaching to achieve guideline recommended risk factor targets can help reduce health inequalities in such patients and thus benefit all patients in the context of ongoing secondary prevention.
Keyword Secondary prevention
Coronary disease
Risk factors
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print: 24 December 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Nursing, Midwifery and Social Work Publications
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Created: Tue, 07 Jan 2014, 19:04:19 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work