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Educating angina patients about their disease reduces hospital admissions
April 12, 2007
www.reutershealth.com
NEW YORK (Reuters Health) - For patients with chronic refractory angina, a brief outpatient cognitive-behavioral intervention aimed at "educating patients and demystifying angina" reduces hospital admissions and improves quality of life, researchers from the UK report.
Chronic refractory angina is "an increasingly prevalent, complex chronic pain condition," which frequently results in hospitalization, Dr. Roger K. Moore from the Cardiothoracic Center, Liverpool and colleagues note in the March Journal of Pain and Symptom Management.
Misconceptions about angina may be partly to blame. The UK team found in a recent survey of 197 chronic refractory angina patients that 30% mistakenly thought angina was a kind of small heart attack, 53% erroneously believed that each episode of angina does more damage to the heart, and 82% thought it was very important to avoid activities that might bring on an attack.
They previously demonstrated that the cognitive-behavioral chronic disease management program aimed at addressing misconceptions and anxiety about angina, which was instituted in Liverpool in 1997, significantly improved angina status and quality of life.
They now have evidence, based on an audit of 271 chronic refractory angina patients who participated in the program, that these individual experiences reflect a measurable effect across the population.
Specifically, the audit showed a decrease in total hospital admissions from 2.40 to 1.78 admissions per patient per year (p < 0.001). In addition, "the rising trend of total hospital bed day occupancy prior to enrollment" fell from 15.48 to a stable 10.34 days per patient year (p < 0.001).
The effects of the angina education intervention were "immediate and sustained," Dr. Moore and colleagues write, which suggests that such programs "may at least pay for themselves and that a more detailed health economic analysis is warranted."
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