It's known that an improvement in risk factors and adherence to treatment guidelines lead to better outcomes in patients with cardiovascular disease (CVD). Yet, clinical practice often falls short of achieving the risk factor goals recommended by the guidelines. The Coaching on Achieving Cardiovascular Health (COACH) program, a standardized, evidence-based coaching program, was developed to address this treatment gap by advising patients on how to achieve these goals. Researchers evaluated the long-term impact of the program on survival, hospital utilization, and costs in patients with CVD.

Eligible patients were randomized to either an intervention group that received usual care plus the COACH program, which comprised up to six coaching sessions during a six-month period, or a control group that received usual care only. There were 512 patients in each group, and mean follow-up was 6.35 years.

Eighty-six deaths occurred in the intervention group compared with 112 in the control group, for a statistically significant absolute reduction of 5% in all-cause mortality in those in the COACH program. A dose-response effect was observed: the reduction in mortality was significant only in patients who received four or more coaching sessions. Total per-patient net cost to the health insurer was more than $12,000 less in the intervention group than in the control group, but, again, the difference was only significant after patients had received four or more coaching sessions. The number of hospital admissions and lengths of hospital stay were also lower in the intervention than the control group, although the differences weren't significant.

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