Study Shows NP Intervention Proves Valuable
by Jon Eichberger
“Community Outreach and Cardiovascular Health (COACH) Trial: A Randomized, Controlled Trial of Nurse Practitioner/Community Health Worker Cardiovascular Disease Risk Reduction in Urban Community Health Centers,” was an editor’s pick in the November 2011 issue of the American Heart Association (AHA) journal, Circulation: Cardiovascular Quality and Outcomes.
The COACH trial, funded by the National Institutes of Health, was led by associate dean for research and M. Adelaide Nutting Chair Jerilyn Allen, ScD, RN, and included fellow Johns Hopkins University School of Nursing researchers Cheryl Dennison Himmelfarb, PhD, RN; Sarah Szanton, PhD, CRNP; dean Martha N. Hill, PhD, RN; and Mary Donnelly-Strozzo, DNP, MPH.
The study shows that direct inter-vention by nurses with cardiovascular disease (CVD) patients has a positive effect on improving cardiovascular care in underserved populations.
The trial randomly assigned patients with documented CVD, type-2 diabetes, high cholesterol, or hypertension into two groups: a nurse practitioner/community health worker (NP/CHW) group and an enhanced usual care group. The NP/CHW team focused on lifestyle changes based on behavioral interventions and the prescription of appropriate medications. Strategies to improve adherence were also integrated.
After 12 months, the NP/CHW patients had a significantly greater reduction in total cholesterol, bad LDL cholesterol, triglycerides, systolic and diastolic blood pressure, and HbA1c—a test that measures sugar in the blood. The NP/CHW patients also had an improved perception of the quality of their chronic illness care.
“Our results demonstrate the value of nurse practitioner interventions and add to the collective research that has already been done in nurse case management in cardiovascular care,” Allen notes. “It is time to translate these effective strategies into practice to improve the cardiovascular health of high-risk populations in urban settings across the country.”