Guideline-based early rehabilitation after myocardial infarction - A pragmatic randomised controlled trial

Objectives: To determine the effectiveness of individualised educational behavioural treatment delivered by cardiac nurses in hospital compared to usual care for patients following acute myocardial infarction. Methods: One hundred and fourteen consecutive patients were randomised to receive the intervention or usual care. Outcome assessment was by self-report questionnaire (the Hospital Anxiety and Depression Scale and Dartmouth COOP Health Status), interview at I month, and self-report at 3 and 12 months. The primary outcome was improvement in the Dartmouth COOP total score from baseline to 3 months. Results: Four patients needed to be treated to give an additional patient with improvement in health status at 3 months (number needed to treat [NNT] 4, 95% confidence intervals [CIs] 3 to 12). The intervention group were more confident about returning to activities I month after discharge from hospital. Treated patients had fewer further treatment needs. Conclusions: An individualised educational behavioural treatment delivered by cardiac nurses in hospital may have substantial benefits, A large-scale pragmatic RCT is needed. (C) 2002 Elsevier Science Inc. All rights reserved.