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Unique features
A major distinguishing feature of The COACH Program compared with all other coaching programs is that coaches

Evidence-based

The COACH Program has been extensively published in peer reviewed medical journals. This peer reviewed research underpins the evidence-based nature of the Program.

The COACH Program is supported by the highest level of evidence with two published randomised controlled trials which prove that The COACH Program is highly effective in reducing risk factors in patients with cardiovascular disease. An independent audit of the patients in the second randomised controlled trial conducted by the Victorian Department of Human Services proves that The COACH Program keeps patients out of hospital.

Single centre randomised controlled trial of The COACH Program
Vale MJ, Jelinek MV, Best JD, Santamaria JD. Coaching patients with coronary heart disease to achieve the target cholesterol: a method to bridge the gap between evidence-based medicine and the ‘real world’. Randomized controlled trial. J Clin Epidemiol 2002; 55: 245-52.
The first study conducted in 1996-1998 was a single centre randomised controlled trial of 245 patients with coronary heart disease who underwent The COACH Program plus usual care versus usual care only. The study was conducted to answer the question: “Would patients with coronary heart disease achieve better cholesterol results with a coach than without a coach?” Total cholesterol (TC) levels were measured six months after randomisation.The results were: coached patients had significantly lower TC levels (5.00 mmol/L vs 5.54 mmol/L) than did patients who underwent usual medical care only (P<0.0001).

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Multicentre randomised controlled trial of Coaching patients On Achieving Cardiovascular Health (COACH)
Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, Ho BP, Newman RW, McNeil JJ. Coaching Patients On Achieving Cardiovascular Health (COACH); A Multicenter Randomized Trial in Patients with Coronary Heart Disease. Arch Intern Med 2003; 163: 2775-83.
The second study conducted in 1999-2000 was a multicentre randomised controlled trial of 792 patients who were admitted to six university teaching hospitals for CABG; PCI; AMI or unstable angina (and then discharged on medical therapy); or coronary angiography with later planned elective revascularisation.Patients were randomised to The COACH Program plus usual care vs usual care only.Patients were coached to achieve the targets for all of their modifiable risk factorsThe results were: At the end of the 6 month study, coached patients were significantly better than patients who underwent usual care only in achieving lower total cholesterol, LDL cholesterol, lower blood pressure, lower body weight, reduced dietary intake of total fat, saturated fat, cholesterol, increased intake of dietary fibre, increased regular walking habit, reduced patient anxiety, reduced cardiac symptoms of chest pain and breathlessness and improved quality of life.The COACH Program is the world’s first cardiovascular disease management program that has been successful in significantly reducing coronary risk factor levels without involving dietitians or nurses in prescribing medication directly to patients.

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Four-year follow-up of the multicentre randomised controlled trial of Coaching patients On Achieving Cardiovascular Health (The COACH study) shows that The COACH Program keeps patients out of hospital
Vale MJ, Sundararajan V, Jelinek MV, Best JD. Four-year follow-up of the multicenter RCT of Coaching patients On Achieving Cardiovascular Health (The COACH Study) shows that The COACH Program keeps patients out of hospital. Circulation 2004; 110: Suppl: III-801.
A four-year follow-up of the 792 patients in the multicentre COACH study was performed by the Victorian Department of Human Services to determine the impact of The COACH Program on deaths, subsequent readmissions into hospital and subsequent beddays in hospital.The survival of both coached and usual care patients was 92% four years after randomisation.There was a statistically significant 15% reduction in cardiac beddays, 16% reduction in admissions into hospital for any cause, and a 20% reduction in beddays for any cause.Only 4 phone coaching sessions over 6 months (TOTAL OF 2 HOURS OF COACHING TIME) reduced hospital admissions by 16% and beddays by 20% compared to usual care within 4 years after randomisation (P<0.001). The savings started at 1 year and increased incrementally over 4 years.This follow-up study has shown that The COACH Program reduces all cause hospital readmissions and achieves large reductions in hospital stays for cardiac illness and illness of any cause.

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The COACH Program Produces Sustained Improvements in Cardiovascular Risk Factors and Adherence to Recommended Medications —2 Years Follow-up
Jelinek MJ, Vale MJ, Liew D, Grigg L, Dart A, Hare DL, Best JD. The COACH Program produces sustained improvements in cardiovsuclar risk factors and adherence to recommended medications – 2 years follow-up. Heart, Lung and Circulation 2009;18: 388–392.
The aim of this study was to assess whether The COACH Program could sustain its favourable impact on coronary risk factors and adherence to recommended medication for 18 months after the completion of The COACH Program.Of more than 4,000 patients who underwent the 6 month COACH Program from 4 public hospitals in Victoria between Jan 2003 & Dec 2006, 656 patients were prospectively followed at 6 monthly intervals for 18 months after completion of the 6 month COACH Program for measurement of risk factor status and medication adherence.Results showed that the changes in coronary risk factor status and adherence to cardiac medications achieved at 6 months in The COACH Program are sustained for at least 18 months after cessation of The COACH Program.

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Fit for Purpose. The COACH Program improves lifestyle and biomedical cardiac risk factors. Heart. August 5, 2012
Jelinek MV, Santamaria JD, Thompson DR, Vale MJ. ‘Fit for purpose’. The COACH Program improves lifestyle and biomedical risk factors. Heart 2012; 98:1608.
Prospective cohort of 5544 patients with cardiovascular disease who completed the 6 month COACH Program. The COACH Program improved lifestyle and biomedical risk factors which are implicated in the prognosis of CHD.

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Reversing social disadvantage in secondary prevention of coronary heart disease
Jelinek MV, Santamaria JD, Best JD, Thompson DR, Tonkin AM, Vale MV.
International Journal of Cardiology 2014; 171: 346–350.
The aim of this study was to compare and contrast the coronary heart disease (CHD) risk factors of lower socio-economic status public hospital patients with those of privately insured CHD patients before and after six months of using The COACH Program. A retrospective observational study contrasted the lifestyle and biomedical coronary risk factor status of 2256 public hospital patients with the same risk factors of 3278 patients who had private health insurance. All patients received an average of 5 coach sessions of The COACH Program over 6 months.The public hospital patients were four years younger and had multiple measures confirming their lower socio-economic status than their private hospital counterparts. At entry to the program, the public hospital patients had worse risk factor levels than the privately insured patients for total and LDL-cholesterol, triglycerides, fasting glucose, smoking and physical activity levels (P < 0.0001) but better status for systolic and diastolic blood pressures and alcohol intake. At exit from the program, many of these differences had diminished or disappeared. The public hospital patients had greater improvements in their risk factor status for total and LDL-cholesterol, fasting glucose, body weight, smoking status and physical activity level than did the privately insured patients (P < 0.05).This study demonstrates that a program of initiating contact with patients with coronary heart disease, identifying treatment gaps in their management and coaching to achieve guideline recommended risk factor targets can help reduce health inequalities in such patients and thus benefit all patients in the context of ongoing secondary prevention.

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Why it’s
needed

There is a ‘gap’ between the guideline recommended treatments patients with chronic disease should be receiving as against what they are actually receiving.

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The COACH
program

The COACH Program leads the world with its innovative coaching prevention program for people with chronic disease.

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Health
organisations

Australia’s most widely used coaching program for prevention of chronic disease.

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