Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization

PURPOSE: This science clinical paper reviews medical literature and examines interventions that are currently used to assist patients in achieving lifestyle change after myocardial infarction or coronary artery revascularization. Interventions that focused on both provider- and patient-implemented strategies were included. The effectiveness of these interventions to significantly reduce coronary heart disease risk factors was explored. DATA SOURCES: Original longitudinal research studies or reviews indexed in PubMed between 1999 and 2004 were included. Eight studies were identified that met the inclusion criteria and presented successful interventions to increase participants' adherence to recommended lifestyle changes. CONCLUSIONS: Current strategies for achieving recommended risk factor reductions include frequent follow-up, intensive diet changes, individualized and group exercise, coaching, group meetings, education on lifestyle modification and behavior change, and formal cardiac rehabilitation programs. IMPLICATIONS FOR PRACTICE: Nurse Practitioners can help close the gap between evidence-based recommendations and clinical practice by implementing education programs in their practices and in the community. Recommendations include frequent follow-up visits, negotiating personalized treatment plans, and a general emphasis on therapeutic lifestyle change as an essential component of the treatment plan.