Coaching by non-drug prescribing health professionals reduced total cholesterol concentrations in coronary heart disease

摘要

Research on the effectiveness of multicomponent disease management programmes for improving coronary risk profiles is slowly emerging.However, evidence regarding the effectiveness of individual components of these programmes, specifically non-prescribing nurse led interventions, is limited and conflicting.3 The trial by Vale et al rigorously examined the effectiveness of nurse or dietitian coaching on achieving cardiac risk factor targets, particularly serum TC concentrations.Patients from 6 Australian teaching hospitals were contacted by health workers who had received training on the COACH programme. The programme assists patients to aggressively pursue improvements in cardiac risk factors. It reflects common principles of self care: processes are initiated by the individual or in collaboration with a healthcare professional, and involve active client participation in health related decisions and actions.4 The programme focuses on the development of self management skills beyond mere understanding of treatment targets to include proactive communication with physicians and development of action plans.Nurses with or without prescribing authority could incorporate coaching strategies into their care and follow up patients with modifiable risks. Nurses have an important role in supporting and encouragirn patients' self management of chronic illness, and the nature of nursing is well suited to coaching, a function that may enhance the effectiveness of more passive educational strategies.