Randomized controlled trial of a lay-facilitated angina management programme

Aims. This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP). Background. Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes. Design. A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist. Methods. Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6months; secondary outcomes at 3 and 6months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation. Results. There was no important difference in angina frequency at 6months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3months for: Anxiety, angina misconceptions and for exercise report; and at 6months for: Anxiety; Depression; and angina misconceptions. The intervention was considered cost-effective. Conclusion. The angina management programme produced some superior benefits when compared to advice from a specialist nurse. © 2012 Blackwell Publishing Ltd.