Background: Improvement of health-related quality of life (HRQOL) is an important goal in preventive cardiology.\nHRQOL is also related to depressive symptoms, which represent a common co-morbidity and risk factor in patients\nwith an acute coronary syndrome (ACS). Comprehensive nurse-coordinated prevention programmes (NCPP) in\nsecondary care have been shown to reduce cardiovascular risk, however their effects on HRQOL and depressive\nsymptoms have not been evaluated. We therefore investigated HRQOL and depressive symptoms in a secondary\nanalysis in the RESPONSE trial, evaluating the effect of a NCPP on cardiovascular risk.\nMethods: RESPONSE was a multicentre (n = 11) randomised controlled trial in ACS-patients in secondary and\ntertiary healthcare settings evaluating a NCPP. The intervention consisted of four outpatient nurse clinic visits in the\nfirst 6 months after the index event, focusing on healthy lifestyles, biometric risk factors and medication adherence,\nin addition to usual care. The control group received usual care only. The outcome was change in HRQOL as\nmeasured by the MacNew questionnaire and change in depressive symptoms as measured by Beck�s Depression\nInventory (BDI) questionnaire at 12-months follow-up relative to baseline.\nResults: Of 754 patients randomised, 615 were analysed for HRQOL; 120 for depressive symptoms. At baseline, HRQOL\nwas 5.17 (SD 1.09) and 5.20 (SD1.04) (scale range 1.0 to 7.0) in the intervention and control group, respectively. At\n12 months follow-up, HRQOL increased by 0.57 (SD 0.89) in the intervention group as compared with 0.42 (SD 0.90) in\nthe control group (p = 0.03). This increase was observed across all relevant subscales. The BDI decreased by 1.9 in the\nintervention group as compared with 0.03 in the control group (p = 0.03) (scale range 1.0 to 63).\nConclusion: Participation in a NCPP is associated with a modest but statistically significant increase in HRQOL, and a\ndecrease of depressive symptoms, both of which are highly relevant to patients. A reduction in depressive symptoms\nmay in addition contribute to a reduction in the overall risk of recurrent events.
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