A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: The Braveheart Project

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Abstract

Objective

to examine the effects and feasibility of educating and empowering older people with ischaemic heart disease using trained senior lay health mentors.

Design

randomised controlled trial with blinded evaluation.

Setting

Falkirk and District Royal Infirmary.

Participants

inpatients and outpatients aged 60 or over attending secondary care with a diagnosis of angina or acute myocardial infarction. Three-hundred and nineteen entered and 289 completed exit assessments. The intervention group took part in mentoring groups for 1 year, meeting monthly for 2 hours, each led by two trained lay health mentors in addition to standard care.

Main outcome measures

primary outcome measures were changes in coronary risk factors, medication usage and actual use of secondary care health services. Secondary outcomes were total and cardiovascular events; changes in medication compliance, non-medical support requirement, health status and psychological functioning, and social inclusion.

Results

there were significant improvements in a reported current exercise score (mean +0.33, +0.02 to +0.52), in the average time spent walking per week by 72 minutes (+1 to +137 minutes), and in the SF36 Physical Functioning Score (+6.1, +2.4 to +9.5). There was a 1.0% reduction in total fat (95% CI −3.0% to −0.6%) and a 0.6% reduction in saturated fat (95% CI −1.5% to −0.03%). The intervention group showed reduced outpatient attendance for coronary heart disease (−0.25 appointments, −0.61 to −0.08). Attendance rates were high. Socio-economic grouping did not affect participation.

Conclusions

Lay Health Mentoring is feasible, practical and inclusive, positively influencing diet, physical activity, and health resource utilisation in older subjects with ischaemic heart disease without causing harm.

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