Abstract P124: Provider Recommendations and Patient Intentions and Confidence to Make Lifestyle Changes Following Acute Coronary Syndromes: Preliminary Data from TRACE-CORE
Background: Lifestyle changes are associated with prognosis following acute coronary syndromes (ACS). Less is known about patients’ intentions or confidence in their ability to make changes.
Purpose: To examine patient report of provider lifestyle recommendations post-ACS and their intentions and confidence to make changes.
Methods: Adults in central MA or GA were interviewed during hospitalization for ACS and at 1 month (1M) as part of the NHLBI-funded Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE). At 1M (n=253 to date), patients reported recommendations by clinicians during hospitalization or follow-up visit, intentions (no plans, thinking about, or started to make changes), and confidence (not at all/somewhat, moderately, or very/completely confident). X2 or Fisher’s exact tests provided p-values.
Results: Participants were 65% male, 82% non-Hispanic white and 9% African-American, and aged 61.3±11.0 years. Patient report of provider recommendations ranged from 20% to 83% (Figure). Alcohol reduction was recommended to 13% of occasional, 23% of moderate, and 41% of heavier drinkers (p<0.01). Obese patients were more likely to report weight loss advice (58% versus 14% of overweight patients; p<0.01). Stress management advice was more likely among patients with higher perceived stress (18%, 29%, and 59% across tertiles; p<0.01). Dietary and activity recommendations did not differ by baseline behavior (p=0.13 and p=0.56, respectively). Among patients reporting recommendations, most had started to make changes (range: 54% to 96%; Figure) and intentions were positively associated with confidence for some (diet p<0.01; activity p<0.01; stress p=0.01; cardiac rehab p<0.01) but not all lifestyle changes (alcohol p=1.0; smoking p=0.10; weight p=0.11).
Conclusions: Our findings may reflect less-than-ideal counseling rates or poor patient recall. Low confidence to make lifestyle changes may be an important target for intervention post-ACS.
- © 2012 by American Heart Association, Inc.