human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omized trial of a pharmacist-delivered intervention ( PI ) versus usual care ( UC ) was conducted ; 689 subjects with known coronary heart disease were recruited from cardiac catheterization laboratories . Participants in the PI condition received 5 pharmacist-delivered telephone counseling calls post-hospital discharge . At one year , 65 % in the PI condition and 60 % in the UC condition achieved an LDL-C level < 100 mg/dL ( P = .29 ) ; mean statin adherence was 0.88 in the PI , and 0.90 in the UC ( P = .51 ) . The highest percentage of those who reached the LDL-C goal were participants who used statins as opposed to those who did not use statins ( 67 % versus 58 % , P = .05 ) . However , only 53 % and 56 % of the patients in the UC and PI conditions , respectively , were using statins . We conclude that a pharmacist-delivered intervention aim ed only at improving patient adherence is unlikely to positively affect outcomes . Efforts must be oriented towards influencing physicians to increase statin prescription rates Objective : To determine if the improved risk factor profile at 1 year attributed to the Choice of Health Options In prevention of Cardiovascular Events ( CHOICE ) program was maintained at 4 years . Design : Single-blind r and omized controlled trial with post-hoc 47 ± 6 months follow-up ( 76 % complete ) . Setting : Australian tertiary referral hospital . Patients : Two hundred and eight acute coronary syndrome survivors . Interventions : Acute coronary syndrome survivors not accessing cardiac rehabilitation ( CR )  were r and omized to control ( n = 72 ) or CHOICE ( n = 72 ) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support . A contemporary CR reference group were also recruited ( n = 64 ) . Blinded risk assessment occurred at baseline , 1 and 4 years . Main outcome measures : Total cholesterol , systolic blood pressure , smoking status , physical activity . Results : One year improvements in all the modifiable risk factors achieved in CHOICE were maintained at 4 years . CHOICE and control were well-matched at baseline . At 4 years , there was a trend towards lower total cholesterol in CHOICE compared with controls ( mean 4.0 ± 0.1 vs. 4.2 ± 0.1 mmol/l , P = 0.05 ) , significantly better systolic blood pressure ( mean 132.2 ± 2.1 vs. 136.8 ± 2.0 mmHg , P = 0.01 ) , physical activity scores ( 1200 ± 209 vs. 968 ± 196 metabolic equivalent min/week , P = 0.02 ) and proportion with three or more risk factors above national targets ( 20 vs. 42 % , P = 0.02 ) . Participants in CHOICE were at higher baseline risk than CR but at 4 years they had similar risk factor profiles . Conclusion : Participants in CHOICE maintained favorable changes in coronary risk profile at 4 years compared with control , indicating that CHOICE is an effective long-term intervention among those not accessing facility-based CR Abstract BACKGROUND : Poor mood adjustment to chronic medical illness is often accompanied by decrements in function . OBJECTIVE : To evaluate the effectiveness of a telephone-based intervention for psychologic distress and functional impairment in cardiac illness . DESIGN : R and omized , controlled trial . METHODS : We recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale ( HADS ) with scores indicative of mood disturbances at 1-month postdischarge . Recruited patients were r and omized to experimental or control status . Intervention patients received 6 30-minute telephone counseling sessions to identify and address illness-related fears and concerns . Control patients received usual care . Patients ’ responses to the HADS and the Workplace Social Adjustment Scale ( WSAS ) were collected at baseline , 2 , 3 , and 6 months using interactive voice recognition technology . At baseline , the PRIME-MD was used to establish diagnosis of depression . We used mixed effects regression to study changes in outcomes . RESULTS : We enrolled 100 patients . Mean age was 60 ; 67 % of the patients were male . Findings confirmed that the intervention group had a 27 % improvement in depression symptoms ( P=.05 ) , 27 % in anxiety ( P=.02 ) , and a 38 % improvement in home limitations ( P=.04 ) compared with controls . Symptom improvement tracked those for WSAS measures of home function ( P=.04 ) but not workplace function . CONCLUSIONS : The intervention had a moderate effect on patient ’s emotional and functional outcomes that were observed during a critical period in patients ’ lives . Patient convenience , ease of delivery , and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness OBJECTIVE The purpose of this study was to determine the effectiveness of an information and support telephone intervention for reducing anxiety in patients who have undergone coronary artery bypass graft surgery and their partners . DESIGN The study is a r and omized controlled trial . Intervention began at discharge ; 6 telephone calls were made to patients and partners over 7 weeks . Primary outcome was Beck Anxiety Inventory measured at baseline in hospital , at home on day 3 , week 4 , and week 8 . SAMPLE The subjects were 131 patients who have undergone elective coronary artery bypass graft surgery and their partners . RESULTS Patients ' anxiety was moderate to severe the day before discharge . It was significantly lower in the treatment group than in the control group at day 2 at home . Partners always had lower anxiety than patients . A more sustained decrease in anxiety in the partner treatment group was found at both day 2 and week 4 . CONCLUSION Intervention effect is in the early period after discharge-- the time most affected by reduced lengths of stay Background Home-based cardiac rehabilitation ( CR ) has been demonstrated to be as effective as institution-based CR in post-coronary artery bypass graft surgery ( CABG ) patients in terms of short-term physical and psychosocial outcomes . The sustainability of these effects is less well studied . The aim of this study was to examine the sustainability of observed changes in physical , quality of life ( HRQL ) , and social support ( SS ) outcomes in patients 12 months after discharge from a r and omized controlled trial ( RCT ) of 6 months of monitored home-based versus supervised hospital-based CR .  Design Two-hundred and twenty-two ( n = 222 ) patients were followed-up 12 months after discharge from a RCT of 6 months of monitored ‘ Home ' versus supervised ‘ Hospital ' CR after CABG . Methods At discharge from the 6-month RCT , participants who consented to the 12-month follow-up study , were given individualized guidelines for ongoing exercise , and were not contacted for 1 year . The primary outcome was peak oxygen uptake ( VO2 ) . Secondary outcomes were : HRQL , SS and habitual physical activity .  Results One hundred and ninety-eight patients ( 89.2 % ) , 102 ‘ Hospital ' and 96 ‘ Home ' , returned for follow-up 12-months after discharge from CR . Both groups had similar medical and socio-demographic characteristics . Peak VO2 declined in ‘ Hospital ' but was sustained in ‘ Home ' patients 12 months after discharge from CR ( P=0.002 ) . Physical HRQL was higher in the ‘ Home ' group at the 12-month follow-up ( P<0.01 ) . Mental HRQL showed general , minor deterioration over time in both groups ( P=0.019 ) . Twelve months after discharge from CR , physical and mental HRQL remained higher than at entry to CR in both groups . ‘ Home ' patients had higher habitual physical activity scores compared to ‘ Hospital ' patients . Conclusions This follow-up study suggests that low-risk patients whose CR  is initiated in the home environment may be more likely to sustain positive physical and psychosocial changes over time than patients whose program is initially institution-based The purpose of this trial was to determine the effectiveness of advanced practice nursing support on cardiac surgery patients ’ during the first 5 weeks following hospital discharge . Patients ( N = 200 ) were r and omly allocated to two groups : ( a ) an intervention group who received telephone calls from an advanced practice nurse ( APN ) familiar with their clinical condition and care needs , twice during the first week following discharge then weekly thereafter for 4 weeks , and ( b ) a usual care group . Measures of health-related quality of life ( HRQL ) , symptom distress , satisfaction with recovery care , and unexpected health care contacts were obtained at 5 weeks following discharge . There were no significant group differences in HRQL , unexpected contacts with the health care system , or symptom distress . The provision of APN support via telephone followup after cardiac surgery is feasible . However , further r and omized trials of single and multicomponent APN interventions are needed to prove effectiveness Background Providing information is an important part of st and ard care and treatment for acute myocardial infa rct ion in patients . Evidence exists indicating that acute myocardial infa rct ion patients experience an information gap in the period immediately after discharge from the hospital . The aim of this study was to assess the short-term effects of a nurse-led telephone follow-up intervention to provide information and support to patients with acute myocardial infa rct ion after their discharge from hospital . Design and method A prospect i ve r and omized , controlled trial with a 6-month follow-up was conducted . A total of 288 patients were allocated to either an intervention group ( n = 156 ) or a control group ( n = 132 ) . The latter received routine post-discharge care . The primary endpoint measured at 3 and 6 months after discharge was the health-related quality of life using the 36-item Short Form Health Survey . Secondary endpoints included smoking and exercise habits . Results In both groups , health-related quality of life improved significantly over time on most subscales . A statistically significant difference in favour of the intervention group was found on the 36-item Short Form Health Survey Physical Health Component Summary Scale ( P=0.034 ) after 6 months . No difference was found between the groups on the Mental Health Component Summary Scale . We found a significant difference with respect to frequency of physical activity in favour of the intervention group after 6 months ( P=0.004 ) . More participants in the intervention group than the control group had ceased smoking at the 6-month follow-up ( P=0.055 ) . Conclusion A nurse-led systematic telephone follow-up intervention significantly improved the physical dimension of health-related quality of life in patients in the intervention group compared with usual care patients . Participation in this intervention also seemed to promote health behaviour change in patients after acute myocardial infa rct ion OBJECTIVE The purpose of this study was to test the effect of a post-discharge telephone counseling intervention on women 's psychosocial adjustment following a cardiac event . DESIGN The study was a prospect i ve , r and omized , controlled trial . PATIENTS Women ( n = 196 ) were recruited from 4 hospitals in Sydney , Australia , who were hospitalized for coronary artery disease : myocardial infa rct ion , coronary artery bypass grafts , coronary angioplasty , or stable angina . Women were r and omized to usual care ( n = 103 ) or telephone counseling ( n = 93 ) and were 67 years of age ( range 34 - 92 ) . The majority had not completed high school ( 92 % ) and were not employed ( 84 % ) . OUTCOMES Psychosocial adjustment was measured by the Psychosocial Adjustment to Illness Scale and the Hospital Anxiety and Depression Scale the day before hospital discharge and 12 weeks postdischarge . INTERVENTION Individualized information and support , was design ed to promote self-managed recovery and psychosocial adjustment , and began with an evaluation during admission and was followed up by telephone counseling at 1 , 2 , 3 , and 6 weeks after discharge . RESULTS The intervention had no effect on psychosocial adjustment ( F[1,182 ] = 0.06 , P = .8 ) , anxiety ( F[1,182 ] = 0.15 , P = .69 ) or depression ( F[1,182 ] = 0.11 , P = .74 ) at 12 weeks after discharge . Women made significant improvements during the 12 weeks on mean scores for psychosocial adjustment ( F[1,182 ] = 58.37 , P = .00 ) , anxiety ( F [ 1,182 ] = 74.58 , P = .00 ) and depression ( F[1,182 ] = 14.11 , P = .00 ) . The predictors of poor psychosocial outcomes for women included being less than 55 years of age , being unemployed or retired , having poor psychosocial adjustment to illness at baseline , having readmission , or experiencing a stressful , personal event during follow-up . CONCLUSIONS Women at risk for poor outcomes following hospitalization for a cardiac event can be identified ( ie , women less than 55 years of age , unemployed or retired , poorly adjusted to their cardiac illness , or readmitted to hospital within 12 weeks of a previous cardiac admission ) , but an effective intervention to enhance psychosocial outcomes remains to be established BACKGROUND Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease . However , those disease management programs in which drugs are not prescribed by allied health professionals 
    Output:
    
agent
Conclusions Compared to st and ard post-discharge care , regular telephone support interventions may help reduce feelings of anxiety and depression as well as , improve systolic blood pressure control and the likelihood of smoking cessation
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omized trial of a pharmacist-delivered intervention ( PI ) versus usual care ( UC ) was conducted ; 689 subjects with known coronary heart disease were recruited from cardiac catheterization laboratories . Participants in the PI condition received 5 pharmacist-delivered telephone counseling calls post-hospital discharge . At one year , 65 % in the PI condition and 60 % in the UC condition achieved an LDL-C level < 100 mg/dL ( P = .29 ) ; mean statin adherence was 0.88 in the PI , and 0.90 in the UC ( P = .51 ) . The highest percentage of those who reached the LDL-C goal were participants who used statins as opposed to those who did not use statins ( 67 % versus 58 % , P = .05 ) . However , only 53 % and 56 % of the patients in the UC and PI conditions , respectively , were using statins . We conclude that a pharmacist-delivered intervention aim ed only at improving patient adherence is unlikely to positively affect outcomes . Efforts must be oriented towards influencing physicians to increase statin prescription rates Objective : To determine if the improved risk factor profile at 1 year attributed to the Choice of Health Options In prevention of Cardiovascular Events ( CHOICE ) program was maintained at 4 years . Design : Single-blind r and omized controlled trial with post-hoc 47 ± 6 months follow-up ( 76 % complete ) . Setting : Australian tertiary referral hospital . Patients : Two hundred and eight acute coronary syndrome survivors . Interventions : Acute coronary syndrome survivors not accessing cardiac rehabilitation ( CR )  were r and omized to control ( n = 72 ) or CHOICE ( n = 72 ) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support . A contemporary CR reference group were also recruited ( n = 64 ) . Blinded risk assessment occurred at baseline , 1 and 4 years . Main outcome measures : Total cholesterol , systolic blood pressure , smoking status , physical activity . Results : One year improvements in all the modifiable risk factors achieved in CHOICE were maintained at 4 years . CHOICE and control were well-matched at baseline . At 4 years , there was a trend towards lower total cholesterol in CHOICE compared with controls ( mean 4.0 ± 0.1 vs. 4.2 ± 0.1 mmol/l , P = 0.05 ) , significantly better systolic blood pressure ( mean 132.2 ± 2.1 vs. 136.8 ± 2.0 mmHg , P = 0.01 ) , physical activity scores ( 1200 ± 209 vs. 968 ± 196 metabolic equivalent min/week , P = 0.02 ) and proportion with three or more risk factors above national targets ( 20 vs. 42 % , P = 0.02 ) . Participants in CHOICE were at higher baseline risk than CR but at 4 years they had similar risk factor profiles . Conclusion : Participants in CHOICE maintained favorable changes in coronary risk profile at 4 years compared with control , indicating that CHOICE is an effective long-term intervention among those not accessing facility-based CR Abstract BACKGROUND : Poor mood adjustment to chronic medical illness is often accompanied by decrements in function . OBJECTIVE : To evaluate the effectiveness of a telephone-based intervention for psychologic distress and functional impairment in cardiac illness . DESIGN : R and omized , controlled trial . METHODS : We recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale ( HADS ) with scores indicative of mood disturbances at 1-month postdischarge . Recruited patients were r and omized to experimental or control status . Intervention patients received 6 30-minute telephone counseling sessions to identify and address illness-related fears and concerns . Control patients received usual care . Patients ’ responses to the HADS and the Workplace Social Adjustment Scale ( WSAS ) were collected at baseline , 2 , 3 , and 6 months using interactive voice recognition technology . At baseline , the PRIME-MD was used to establish diagnosis of depression . We used mixed effects regression to study changes in outcomes . RESULTS : We enrolled 100 patients . Mean age was 60 ; 67 % of the patients were male . Findings confirmed that the intervention group had a 27 % improvement in depression symptoms ( P=.05 ) , 27 % in anxiety ( P=.02 ) , and a 38 % improvement in home limitations ( P=.04 ) compared with controls . Symptom improvement tracked those for WSAS measures of home function ( P=.04 ) but not workplace function . CONCLUSIONS : The intervention had a moderate effect on patient ’s emotional and functional outcomes that were observed during a critical period in patients ’ lives . Patient convenience , ease of delivery , and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness OBJECTIVE The purpose of this study was to determine the effectiveness of an information and support telephone intervention for reducing anxiety in patients who have undergone coronary artery bypass graft surgery and their partners . DESIGN The study is a r and omized controlled trial . Intervention began at discharge ; 6 telephone calls were made to patients and partners over 7 weeks . Primary outcome was Beck Anxiety Inventory measured at baseline in hospital , at home on day 3 , week 4 , and week 8 . SAMPLE The subjects were 131 patients who have undergone elective coronary artery bypass graft surgery and their partners . RESULTS Patients ' anxiety was moderate to severe the day before discharge . It was significantly lower in the treatment group than in the control group at day 2 at home . Partners always had lower anxiety than patients . A more sustained decrease in anxiety in the partner treatment group was found at both day 2 and week 4 . CONCLUSION Intervention effect is in the early period after discharge-- the time most affected by reduced lengths of stay Background Home-based cardiac rehabilitation ( CR ) has been demonstrated to be as effective as institution-based CR in post-coronary artery bypass graft surgery ( CABG ) patients in terms of short-term physical and psychosocial outcomes . The sustainability of these effects is less well studied . The aim of this study was to examine the sustainability of observed changes in physical , quality of life ( HRQL ) , and social support ( SS ) outcomes in patients 12 months after discharge from a r and omized controlled trial ( RCT ) of 6 months of monitored home-based versus supervised hospital-based CR .  Design Two-hundred and twenty-two ( n = 222 ) patients were followed-up 12 months after discharge from a RCT of 6 months of monitored ‘ Home ' versus supervised ‘ Hospital ' CR after CABG . Methods At discharge from the 6-month RCT , participants who consented to the 12-month follow-up study , were given individualized guidelines for ongoing exercise , and were not contacted for 1 year . The primary outcome was peak oxygen uptake ( VO2 ) . Secondary outcomes were : HRQL , SS and habitual physical activity .  Results One hundred and ninety-eight patients ( 89.2 % ) , 102 ‘ Hospital ' and 96 ‘ Home ' , returned for follow-up 12-months after discharge from CR . Both groups had similar medical and socio-demographic characteristics . Peak VO2 declined in ‘ Hospital ' but was sustained in ‘ Home ' patients 12 months after discharge from CR ( P=0.002 ) . Physical HRQL was higher in the ‘ Home ' group at the 12-month follow-up ( P<0.01 ) . Mental HRQL showed general , minor deterioration over time in both groups ( P=0.019 ) . Twelve months after discharge from CR , physical and mental HRQL remained higher than at entry to CR in both groups . ‘ Home ' patients had higher habitual physical activity scores compared to ‘ Hospital ' patients . Conclusions This follow-up study suggests that low-risk patients whose CR  is initiated in the home environment may be more likely to sustain positive physical and psychosocial changes over time than patients whose program is initially institution-based The purpose of this trial was to determine the effectiveness of advanced practice nursing support on cardiac surgery patients ’ during the first 5 weeks following hospital discharge . Patients ( N = 200 ) were r and omly allocated to two groups : ( a ) an intervention group who received telephone calls from an advanced practice nurse ( APN ) familiar with their clinical condition and care needs , twice during the first week following discharge then weekly thereafter for 4 weeks , and ( b ) a usual care group . Measures of health-related quality of life ( HRQL ) , symptom distress , satisfaction with recovery care , and unexpected health care contacts were obtained at 5 weeks following discharge . There were no significant group differences in HRQL , unexpected contacts with the health care system , or symptom distress . The provision of APN support via telephone followup after cardiac surgery is feasible . However , further r and omized trials of single and multicomponent APN interventions are needed to prove effectiveness Background Providing information is an important part of st and ard care and treatment for acute myocardial infa rct ion in patients . Evidence exists indicating that acute myocardial infa rct ion patients experience an information gap in the period immediately after discharge from the hospital . The aim of this study was to assess the short-term effects of a nurse-led telephone follow-up intervention to provide information and support to patients with acute myocardial infa rct ion after their discharge from hospital . Design and method A prospect i ve r and omized , controlled trial with a 6-month follow-up was conducted . A total of 288 patients were allocated to either an intervention group ( n = 156 ) or a control group ( n = 132 ) . The latter received routine post-discharge care . The primary endpoint measured at 3 and 6 months after discharge was the health-related quality of life using the 36-item Short Form Health Survey . Secondary endpoints included smoking and exercise habits . Results In both groups , health-related quality of life improved significantly over time on most subscales . A statistically significant difference in favour of the intervention group was found on the 36-item Short Form Health Survey Physical Health Component Summary Scale ( P=0.034 ) after 6 months . No difference was found between the groups on the Mental Health Component Summary Scale . We found a significant difference with respect to frequency of physical activity in favour of the intervention group after 6 months ( P=0.004 ) . More participants in the intervention group than the control group had ceased smoking at the 6-month follow-up ( P=0.055 ) . Conclusion A nurse-led systematic telephone follow-up intervention significantly improved the physical dimension of health-related quality of life in patients in the intervention group compared with usual care patients . Participation in this intervention also seemed to promote health behaviour change in patients after acute myocardial infa rct ion OBJECTIVE The purpose of this study was to test the effect of a post-discharge telephone counseling intervention on women 's psychosocial adjustment following a cardiac event . DESIGN The study was a prospect i ve , r and omized , controlled trial . PATIENTS Women ( n = 196 ) were recruited from 4 hospitals in Sydney , Australia , who were hospitalized for coronary artery disease : myocardial infa rct ion , coronary artery bypass grafts , coronary angioplasty , or stable angina . Women were r and omized to usual care ( n = 103 ) or telephone counseling ( n = 93 ) and were 67 years of age ( range 34 - 92 ) . The majority had not completed high school ( 92 % ) and were not employed ( 84 % ) . OUTCOMES Psychosocial adjustment was measured by the Psychosocial Adjustment to Illness Scale and the Hospital Anxiety and Depression Scale the day before hospital discharge and 12 weeks postdischarge . INTERVENTION Individualized information and support , was design ed to promote self-managed recovery and psychosocial adjustment , and began with an evaluation during admission and was followed up by telephone counseling at 1 , 2 , 3 , and 6 weeks after discharge . RESULTS The intervention had no effect on psychosocial adjustment ( F[1,182 ] = 0.06 , P = .8 ) , anxiety ( F[1,182 ] = 0.15 , P = .69 ) or depression ( F[1,182 ] = 0.11 , P = .74 ) at 12 weeks after discharge . Women made significant improvements during the 12 weeks on mean scores for psychosocial adjustment ( F[1,182 ] = 58.37 , P = .00 ) , anxiety ( F [ 1,182 ] = 74.58 , P = .00 ) and depression ( F[1,182 ] = 14.11 , P = .00 ) . The predictors of poor psychosocial outcomes for women included being less than 55 years of age , being unemployed or retired , having poor psychosocial adjustment to illness at baseline , having readmission , or experiencing a stressful , personal event during follow-up . CONCLUSIONS Women at risk for poor outcomes following hospitalization for a cardiac event can be identified ( ie , women less than 55 years of age , unemployed or retired , poorly adjusted to their cardiac illness , or readmitted to hospital within 12 weeks of a previous cardiac admission ) , but an effective intervention to enhance psychosocial outcomes remains to be established BACKGROUND Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease . However , those disease management programs in which drugs are not prescribed by allied health professionals 
    Output:
    