Patients’ and practice nurses’ perceptions of secondary preventive care for established ischaemic heart disease: a qualitative study

• A significant proportion of patients with established ischaemic heart disease remain unrecognized in general practice and those who are receiving treatment are experiencing sub‐optimal care. • The provision of coronary prevention by practice nurses may be an important strategy to improve the quality of this care, and this is feasible and effective. • This study explored what occurred during patients’ initial assessment for secondary prevention of ischaemic heart disease with a practice nurse and investigated patients’ and practice nurses’ views of nurse‐led clinics in primary care. • Nurses were effective in history taking and offering reassurance and dietary advice, yet were less confident in discussing patients’ understandings of heart disease and related medication. • Practice nurse‐led coronary preventive care is acceptable to both nurses and patients. • Further practice nurse education is required in heart disease, cardiac medications and skills necessary for exploring and challenging patients’ understandings of these issues.