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Intended for Healthcare Professionals
British Journal of General Practice

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Research Article

A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.

R J P Lewin, G Furze, J Robinson, K Griffith, S Wiseman, M Pye and R Boyle
British Journal of General Practice 2002; 52 (476): 194-201.
R J P Lewin
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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G Furze
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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J Robinson
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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K Griffith
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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S Wiseman
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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M Pye
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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R Boyle
British Heart Foundation Rehabilitation Unit, Department of Health Studies, University of York. RJPL1@york.ac.uk
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Abstract

BACKGROUND: There are approximately 1.8 million patients with angina in the United Kingdom, many of whom report a poor quality of life, including raised levels of anxiety and depression. AIM: To evaluate the effect of a cognitive behavioural disease management programme, the Angina Plan, on psychological adjustment in patients newly diagnosed with angina pectoris. DESIGN OF STUDY: Randomised controlled trial. SETTING: Patients from GP practices in a Northern UK city (York) between April 1999 and May 2000. METHOD: Recruited patients were randomised to receive the Angina Plan or to a routine, practice nurse-led secondary prevention educational session. RESULTS: Twenty of the 25 practices invited to join the study supplied patients' names; 142 patients attended an assessment clinic and were randomised There were no significant differences in any baseline measures. At the six month post-treatment follow-up, 130 (91%) patients were reassessed. When compared with the educational session patients (using analysis of covariance adjusted for baseline scores in an intention-to-treat analysis) Angina Plan patients showed a greater reduction in anxiety (P = 0.05) and depression (P = 0.01), the frequency of angina (reduced by three episodes per week, versus a reduction of 0.4 per week, P = 0.016) the use of glyceryl trinitrate (reduced by 4.19 fewer doses per week versus a reduction of 0.59 per week, P = 0.018), and physical limitations (P<0.001: Seattle Angina Questionnaire). They were also more likely to report having changed their diet (41 versus 21, P<0.001) and increased their daily walking (30 versus 2, P<0.001). There was no significant difference between the groups on the other sub-scales of the Seattle Angina Questionnaire or in any of the medical variables measured. CONCLUSION: The Angina Plan appears to improve the psychological, symptomatic, and functional status of patients newly diagnosed with angina.

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British Journal of General Practice: 52 (476)
British Journal of General Practice
Vol. 52, Issue 476
March 2002
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A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
R J P Lewin, G Furze, J Robinson, K Griffith, S Wiseman, M Pye, R Boyle
British Journal of General Practice 2002; 52 (476): 194-201.

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A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
R J P Lewin, G Furze, J Robinson, K Griffith, S Wiseman, M Pye, R Boyle
British Journal of General Practice 2002; 52 (476): 194-201.
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Print ISSN: 0960-1643
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