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Age and Ageing Advance Access originally published online on May 10, 2004
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Age and Ageing 2004; 33: 348-354
Age and Ageing Vol. 33 No. 4 © British Geriatrics Society 2004; all rights reserved

Research Paper

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

Andrew J. Coull1, Valerie H. Taylor2, Rob Elton3, Peter S. Murdoch4 and Allister D. Hargreaves4

1 Stroke Prevention Research Unit, Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK
2 Dalkeith Medical Practice, Dalkeith, Midlothian, UK
3 Department of Public Health Sciences, University of Edinburgh, Edinburgh, UK
4 Falkirk and District Royal Infirmary, Majors Loan, Falkirk FK1 5QE, UK

Address correspondence to: P. Murdoch, Department of Geriatric Medicine, Falkirk Royal Infirmary, Majors Loan, Falkirk FK1 5QE, UK. Fax: (+44) 1324 616149. Email: peter.murdoch{at}fvah.scot.nhs.uk

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.

Keywords: mentoring, volunteer, ischaemic heart disease, risk factors, social inclusion, elderly

Received July 30, 2003; Revision received December 30, 2003. accepted in revised form December 30, 2003.


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