Evidence map›Paper›PMID 12521974›Full record

Trial reportBMJ (Clinical research ed.)2003

Secondary prevention clinics for coronary heart disease: four year follow up of a randomised controlled trial in primary care.

Peter Murchie, Neil C Campbell, Lewis D Ritchie, Julie A Simpson, Joan Thain

Open access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 16 pooled it
17.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 16 syntheses or guidelines pooled it, 281 citations in OpenAlex.

  1. Pooled it
  2. Nursing interventions for smoking cessation.The Cochrane database of systematic reviews · 2017
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  3. Patient education in the management of coronary heart disease.The Cochrane database of systematic reviews · 2017
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  5. Guideline
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  9. Primary care organisational interventions for secondary prevention of ischaemic heart disease: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015
    Pooled it
  10. Yoga for secondary prevention of coronary heart disease.The Cochrane database of systematic reviews · 2015
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Peter MurchieDepartment of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen AB25 2AY, UK. p.murchie@abdn.ac.uk
Neil C Campbell
Lewis D Ritchie
Julie A Simpson
Joan Thain
University of Aberdeen · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effects of nurse led clinics in primary care on secondary prevention, total mortality, and coronary event rates after four years.

designFollow up of a randomised controlled trial by postal questionnaires and review of case notes and national datasets.

settingStratified, random sample of 19 general practices in north east Scotland.

participants1343 patients (673 intervention and 670 control) under 80 years with a working diagnosis of coronary heart disease but without terminal illness or dementia and not housebound.

interventionNurse led secondary prevention clinics promoted medical and lifestyle components of secondary prevention and offered regular follow up for one year.

main outcome measuresComponents of secondary prevention (aspirin, blood pressure management, lipid management, healthy diet, exercise, non-smoking), total mortality, and coronary events (non-fatal myocardial infarctions and coronary deaths).

resultsMean follow up was at 4.7 years. Significant improvements were shown in the intervention group in all components of secondary prevention except smoking at one year, and these were sustained after four years except for exercise. The control group, most of whom attended clinics after the initial year, caught up before final follow up, and differences between groups were no longer significant. At 4.7 years, 100 patients in the intervention group and 128 in the control group had died: cumulative death rates were 14.5% and 18.9%, respectively (P=0.038). 100 coronary events occurred in the intervention group and 125 in the control group: cumulative event rates were 14.2% and 18.2%, respectively (P=0.052). Adjusting for age, sex, general practice, and baseline secondary prevention, proportional hazard ratios were 0.75 for all deaths (95% confidence intervals 0.58 to 0.98; P=0.036) and 0.76 for coronary events (0.58 to 1.00; P=0.049)

conclusionsNurse led secondary prevention improved medical and lifestyle components of secondary prevention and this seemed to lead to significantly fewer total deaths and probably fewer coronary events. Secondary prevention clinics should be started sooner rather than later.

Indexed as

Nurse PractitionersAdultAgedAmbulatory CareCoronary DiseaseExerciseFamily PracticeFollow-Up StudiesHealth PromotionHumansLife StyleMiddle AgedPrimary Health CareProportional Hazards ModelsScotlandSmoking Cessation

Identifiers

PMID12521974
PMCPMC139939
OpenAlexW1966482774

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.