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

• Published in: Age and ageing Vol. 33; no. 4; pp. 348 - 354
• Main Authors: Coull, Andrew J., Taylor, Valerie H., Elton, Rob, Murdoch, Peter S., Hargreaves, Allister D.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-07-2004; Oxford Publishing Limited (England)
• Subjects: Aged; Blood circulation disorders; Cardiovascular disease; Clinical trials; Education; Elderly; Elderly people; Empowerment; Female; Geriatrics; Health behaviour; Health education; Humans; ischaemic heart disease; Ischaemic heart diseases; Lay people; Male; Mentoring; Mentors; Middle Aged; Myocardial Ischemia - psychology; Myocardial Ischemia - therapy; Patient Compliance; Patient education; Randomized controlled trials; risk factors; Scotland; social inclusion; Socioeconomic Factors; Treatment Outcome; Vascular diseases; volunteer; United Kingdom
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afh098

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.