1. Carroll, Diane L. PhD, APRN,BC
  2. Rankin, Sally H. PhD, RN, FAAN

Article Content


We assessed the hypothesis that a randomized group of cardiacelders, coached by peer advisors (PA), would be significantly more likelyto adhere to medical recommendations and less likely to be rehospitalized than cardiac elders not assigned to the intervention group.



Unmarried elders, over 65 years of age, lack in-home partner support and have poorer health outcomes post-MI and CABG than elders who are partnered. Provision of peer support from another elder who has suffered the same cardiac event may provide sufficient coaching and enhanced self-efficacy to improve adherence and decrease cardiac rehospitalizations.



Randomized clinical trial.



Unmarried patients (n = 247) were enrolled and randomized while hospitalized post-MI or CABG in 5 US university medical centers. Subjects assigned to the treatment group were matched with another older person who had been trained by Advanced Practice Nurses (APNs) to be a PA. Data were collected at 6 weeks, 3 months, and 1 year after the cardiac event. Measures included the MOS General Adherence 5-item scale and questions pertaining to rehospitalization. Data were analyzed using linear mixed model analyses and generalized estimation effects logistic regression.



Sixty-five percent of the subjects were female, 61% were CABG patients, 80% were retired, 9% were minority, and mean age was 76 years (range, 65-101). Subjects in the intervention group were significantly more likely to adhere to medical recommendations at 1year after the cardiac event than the standard care group (P =.011). Although there were no statistically significant differences between the control and experimental groups for the rehospitalization binary variable, more standard care subjects were rehospitalized for complications at 6 months after the cardiac event than were intervention subjects.



Unpartnered cardiac elders benefit from a low-technology, low-cost intervention by peer advisors even 9 months after the conclusion of the intervention. However, the intervention does not appear to influence rehospitalization rates.


Implications for Practice:

Per support is an efficacious intervention for unpartnered cardiac elders.