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Bernal-Jiménez MÁ, Calle G, Gutiérrez Barrios A, Gheorghe LL, Cruz-Cobo C, Trujillo-Garrido N, Rodríguez-Martín A, Tur JA, Vázquez-García R, Santi-Cano MJ. Effectiveness of an Interactive mHealth App (EVITE) in Improving Lifestyle After a Coronary Event: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e48756. [PMID: 38648103 PMCID: PMC11074898 DOI: 10.2196/48756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/27/2023] [Accepted: 01/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Coronary heart disease is one of the leading causes of mortality worldwide. Secondary prevention is essential, as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve lifestyles. OBJECTIVE This study aimed to evaluate the effect of an mHealth intervention on people with coronary heart disease who received percutaneous coronary intervention. Improvements in lifestyle regarding diet, physical activity, and smoking; level of knowledge of a healthy lifestyle and the control of cardiovascular risk factors (CVRFs); and therapeutic adherence and quality of life were analyzed. METHODS This was a randomized controlled trial with a parallel group design assigned 1:1 to either an intervention involving a smartphone app (mHealth group) or to standard health care (control group). The app was used for setting aims, the self-monitoring of lifestyle and CVRFs using measurements and records, educating people with access to information on their screens about healthy lifestyles and adhering to treatment, and giving motivation through feedback about achievements and aspects to improve. Both groups were assessed after 9 months. The primary outcome variables were adherence to the Mediterranean diet, frequency of food consumed, patient-reported physical activity, smoking, knowledge of healthy lifestyles and the control of CVRFs, adherence to treatment, quality of life, well-being, and satisfaction. RESULTS The study analyzed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (92/128, 71.9%), with a mean age of 59.49 (SD 8.97) years. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (mean 11.83, SD 1.74 points vs mean 10.14, SD 2.02 points; P<.001), frequency of food consumption, patient-reported physical activity (mean 619.14, SD 318.21 min/week vs mean 471.70, SD 261.43 min/week; P=.007), giving up smoking (25/67, 75% vs 11/61, 42%; P=.01), level of knowledge of healthy lifestyles and the control of CVRFs (mean 118.70, SD 2.65 points vs mean 111.25, SD 9.05 points; P<.001), and the physical component of the quality of life 12-item Short Form survey (SF-12; mean 45.80, SD 10.79 points vs mean 41.40, SD 10.78 points; P=.02). Overall satisfaction was higher in the mHealth group (mean 48.22, SD 3.89 vs mean 46.00, SD 4.82 points; P=.002) and app satisfaction and usability were high (mean 44.38, SD 6.18 out of 50 points and mean 95.22, SD 7.37 out of 100). CONCLUSIONS The EVITE app was effective in improving the lifestyle of patients in terms of adherence to the Mediterranean diet, frequency of healthy food consumption, physical activity, giving up smoking, knowledge of healthy lifestyles and controlling CVRFs, quality of life, and overall satisfaction. The app satisfaction and usability were excellent. TRIAL REGISTRATION Clinicaltrials.gov NCT04118504; https://clinicaltrials.gov/study/NCT04118504.
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Affiliation(s)
- María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - German Calle
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Alejandro Gutiérrez Barrios
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Livia Luciana Gheorghe
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Celia Cruz-Cobo
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Nuria Trujillo-Garrido
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Amelia Rodríguez-Martín
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Biomedicine, Biotechnology and Public Health Department, University of Cádiz, Cádiz, Spain
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- Network Biomedical Research Center "Pathophysiology of Obesity and Nutrition", Carlos III Health Institute, Madrid, Spain
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
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Redfern J, Singleton AC, Raeside R, Santo K, Hafiz N, Spencer L, Leung RW, Roberts M, King M, Cho JG, Carr B, Jenkins C, Partridge SR, Hayes A, Chow CK, Hyun K. Integrated Text Messaging (ITM) for people attending cardiac and pulmonary rehabilitation: A multicentre randomised controlled trial. Ann Phys Rehabil Med 2024; 67:101800. [PMID: 38118248 DOI: 10.1016/j.rehab.2023.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/29/2023] [Accepted: 10/17/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND People living with cardiac and respiratory disease require improved post-hospital support that is readily available and efficient. OBJECTIVES To 1) test the effectiveness of an automated, semi-personalised text message support program on clinical and lifestyle outcomes amongst people attending cardiac and pulmonary rehabilitation. Also, 2) to evaluate the program's acceptability and utility using patient-reported outcome and experience measures. METHODS Multicentre randomised controlled trial (3:1, intervention:control) amongst cardiac and pulmonary rehabilitation attendees. Control received usual care (no message program). Intervention also received a 6-month text message lifestyle and support program. Primary outcome was 6-minute walk distance (6MWD). Secondary outcomes included clinical measures, lifestyle, patient-reported outcome and experience measures, medication adherence and rehabilitation attendance. RESULTS A total of 316 participants were recruited. They had a mean age of 66.7 (SD 10.1) years. Sixty percent were male (190/316) and 156 were cardiac rehabilitation participants. The cohort's mean baseline 6MWD was higher in the intervention than the control group. At 6 months, 6MWD improved in both groups; it was significantly greater amongst intervention than control participants (unadjusted mean difference of 43.4 m, 95 % CI 4.3 to 82.4; P = 0.0296). After adjustment for baseline values, there was no significant difference between intervention and control groups for 6MWD (adjusted mean difference 2.2 m, -21.2 to 25.6; P = 0·85), medication adherence, or cardiovascular risk factors. At 6-month follow-up, intervention participants reported significantly lower depression scores (adjusted mean difference -1.3, 95 % CI -2.2 to -0.3; P = 0.0124) and CAT scores (adjusted mean difference -3.9, 95 % CI -6.6 to -1.3; P = 0.0038), and significantly lower anxiety (adjusted mean difference -1.1, 95 %CI -2.1 to 0; P = 0.0456). Most participants (86 %) read most of their messages and strongly/agreed that the intervention was easy to understand (99 %) and useful (86 %). CONCLUSIONS An educational and supportive text message program for cardiac and pulmonary rehabilitation attendees improved anxiety and depression plus program attendance. The program was acceptable to, and useful for, participants and would be suitable for implementation alongside rehabilitation programs. TRIAL REGISTRATION NUMBER ACTRN12616001167459.
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Affiliation(s)
- Julie Redfern
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney; The George Institute for Global Health, University of New South Wales, NSW, Australia.
| | - Anna C Singleton
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Rebecca Raeside
- MPH, Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Karla Santo
- Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil; The George Institute for Global Health, University of New South Wales, NSW, Australia
| | - Nashid Hafiz
- MIPH, Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Lissa Spencer
- PhD, Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney Local Health District, NSW, Australia
| | - Regina Wm Leung
- PhD, Department of Thoracic Medicine, Concord Repatriation General Hospital, Sydney Local Health District, NSW, Australia
| | - Mary Roberts
- MPal Care, Department of Respiratory and Sleep Medicine, Westmead Hospital, Western Sydney Local Health District, NSW, Australia; Faculty of Medicine and Health, The University of Sydney at Westmead Hospital, NSW, Australia
| | - Meredith King
- B Physiotherapy, Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, NSW, Australia
| | - Jin-Gun Cho
- PhD, Department of Respiratory and Sleep Medicine, Westmead Hospital, NSW, Australia; Faculty of Medicine and Health, University of Sydney at Westmead Hospital, Australia
| | - Bridie Carr
- BA Comms, NSW Agency for Clinical Innovation, NSW, Australia
| | - Christine Jenkins
- PhD, The George Institute for Global Health, Sydney and UNSW Faculty of Medicine and Health, NSW, Australia
| | - Stephanie R Partridge
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Alison Hayes
- PhD, School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Clara K Chow
- PhD, Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney; Western Sydney Local Health District; The George Institute for Global Health, University of New South Wales, NSW, Australia
| | - Karice Hyun
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Cardiology, Concord Repatriation General Hospital, Sydney Local Health District, NSW, Australia
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Cotie LM, Vanzella LM, Pakosh M, Ghisi GLDM. A Systematic Review of Clinical Practice Guidelines and Consensus Statements for Cardiac Rehabilitation Delivery: Consensus, Divergence, and Important Knowledge Gaps. Can J Cardiol 2024; 40:330-346. [PMID: 38376955 DOI: 10.1016/j.cjca.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND After 2020, clinical practice recommendations have been released to inform cardiac rehabilitation (CR) programs of best practices for post-COVID programming. The objective of this systematic review was to identify and summarize recommendations from clinical practice guidelines (CPGs) and consensus statements for CR delivery postpandemic. METHODS Five databases (March 2020 through April 2023), grey literature and Web sites of CR international associations were searched. Inclusion criteria were local, national, and international association-endorsed CPGs, and/or position, expert, and scientific statements related to CR delivery (program models, program elements, and core components). Two researchers independently screened the citations for inclusion. The Appraisal of Guidelines for Research and Evaluation (AGREE) II was used for quality assessment. Results were analyzed in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guidelines. RESULTS Overall, 4890 records were identified; 4 CPGs, 9 position/scientific statements, and 6 expert/Delphi consensus papers were included. All guidelines/statements included information related to program delivery models, with 95% endorsing the use of virtual, hybrid, home-based, and telerehabilitation, especially during the pandemic. Outside of the context of COVID-19, program components including referral, CR indications, CR contraindications, timing, and structure were included in the 4 CPGs and 2 of 15 statements. Recommendations related to CR core components were primarily focused on exercise, with no changes since before the pandemic except for COVID-19 considerations for safety. One guideline was specific to women, and 1 scientific statement to heart failure with preserved ejection fraction. CONCLUSIONS Although 19 documents were identified, CR delivery in low resource settings and for culturally and linguistically diverse populations require attention. Additionally, few recommendations on nutrition, psychosocial counselling, and patient education were reported.
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Affiliation(s)
- Lisa M Cotie
- University Health Network Cardiovascular Prevention and Rehabilitation Program, Toronto, Ontario, Canada
| | - Lais M Vanzella
- University Health Network Cardiovascular Prevention and Rehabilitation Program, Toronto, Ontario, Canada
| | - Maureen Pakosh
- Library and Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Gabriela Lima de Melo Ghisi
- KITE Research Institute, University Health Network and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
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Iliuță L, Andronesi AG, Rac-Albu M, Furtunescu FL, Rac-Albu ME, Scafa-Udriște A, Moldovan H, Panaitescu E. Challenges in Caring for People with Cardiovascular Disease through and beyond the COVID-19 Pandemic: The Advantages of Universal Access to Home Telemonitoring. Healthcare (Basel) 2023; 11:1727. [PMID: 37372846 DOI: 10.3390/healthcare11121727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Cardiovascular prevention was left in second place during the COVID-19 pandemic and the use of telemedicine turned out to be very useful. We aimed to evaluate the effectiveness of a telemedicine application for remote monitoring and treatment adjustments in terms of improving cardiovascular prevention. (2) Methods: A prospective study of 3439 patients evaluated between the 1st of March 2019 and the 1st of March 2022, in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up. We compared four periods: pre-pandemic-Pre-P (1 March 2019-1 March 2020), lockdown-Lock (1 March-1 September 2020), restrictive-pandemic-Restr-P (1 September 2020-1 March 2021), and relaxed-pandemic-Rel-P (1 March 2021-1 March 2022). (3) Results: The average values of total cholesterol (TC), LDL cholesterol, triglycerides, uric acid, and glucose had an increasing trend during Lock and Restr-P, and they decreased close to the baseline level during the Rel-P, with the exception of glucose which remained elevated in Rel-P. The number of patients with newly discovered DM increased significantly in the Rel-P, and 79.5% of them had mild/moderate forms of COVID-19. During Lock and Res-P, the percentage of obese, smoking, or hypertensive patients increased, but probably through the use of telemedicine, we managed to reduce it, although it remained slightly higher than the pre-pandemic level. Physical activity decreased in the first year of the pandemic, but in Rel-P people became more active than before the pandemic. (4) Conclusions: The use of telemedicine for cardiovascular prevention seems to yield favorable results, especially for secondary prevention in the very high-risk group and during the second year.
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Affiliation(s)
- Luminita Iliuță
- Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Cardioclass Clinic for Cardiovascular Disease, 031125 Bucharest, Romania
| | - Andreea Gabriella Andronesi
- Nephrology Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Nephrology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Marius Rac-Albu
- Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Cardioclass Clinic for Cardiovascular Disease, 031125 Bucharest, Romania
| | - Florentina Ligia Furtunescu
- Department of Public Health and Management, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Mădălina-Elena Rac-Albu
- Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Alexandru Scafa-Udriște
- Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Department of Cardiology, Clinical Emergency Hospital, 014461 Bucharest, Romania
| | - Horațiu Moldovan
- Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Clinical Emergency Hospital, 014461 Bucharest, Romania
- Academy of Romanian Scientist (AOSR), 3 Ilfov Street, 050044 Bucharest, Romania
| | - Eugenia Panaitescu
- Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
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Wang LYT, Lua JYH, Chan CXC, Ong RLL, Wee CF, Woo BFY. Health information needs and dissemination methods for individuals living with ischemic heart disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 108:107594. [PMID: 36563574 DOI: 10.1016/j.pec.2022.107594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This review aimed to identify the health information needs and preferred approaches to receive health information of individuals with Ischaemic Heart Disease (IHD). METHODS A systematic review was conducted. Relevant literature, published in English (January 2011 to October 2021), was identified across six databases. Guided by Coulter et al.'s framework for developing patient information materials, thematic analysis was performed. The findings were presented in tables and prose. RESULTS Fifty-nine studies were included. Eleven themes summarised the information needs of individuals with IHD. Each theme was supported with subthemes. Forty-five studies included information on preferred methods of dissemination. CONCLUSIONS Our review has characterised the diverse information needs of individuals living with IHD and dissemination methods for outreach to this population. Such insights inform healthcare providers in formulating patient-centred educational interventions to empower patients to undertake successful behavioural modification. PRACTICE IMPLICATIONS Patient education should be personalised and delivered according to individuals' risks for IHD and modifiable risk factors. The use of web-based dissemination of patient education has gained popularity among healthcare providers but sub-optimal adherence to these web-based interventions limits behavioural modification. Adding elements of in-person patient education session to complement web-based interventions may be more propitious to effecting behavioural modification.
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Affiliation(s)
- Laureen Y T Wang
- Alexandra Hospital, National University Health System, Singapore; National University Heart Centre, Singapore, National University Health System, Singapore
| | | | - Cassandra X C Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel L L Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caitlin F Wee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brigitte F Y Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Predicting Cardiovascular Rehabilitation of Patients with Coronary Artery Disease Using Transfer Feature Learning. Diagnostics (Basel) 2023; 13:diagnostics13030508. [PMID: 36766613 PMCID: PMC9914400 DOI: 10.3390/diagnostics13030508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 02/01/2023] Open
Abstract
Cardiovascular diseases represent the leading cause of death worldwide. Thus, cardiovascular rehabilitation programs are crucial to mitigate the deaths caused by this condition each year, mainly in patients with coronary artery disease. COVID-19 was not only a challenge in this area but also an opportunity to open remote or hybrid versions of these programs, potentially reducing the number of patients who leave rehabilitation programs due to geographical/time barriers. This paper presents a method for building a cardiovascular rehabilitation prediction model using retrospective and prospective data with different features using stacked machine learning, transfer feature learning, and the joint distribution adaptation tool to address this problem. We illustrate the method over a Chilean rehabilitation center, where the prediction performance results obtained for 10-fold cross-validation achieved error levels with an NMSE of 0.03±0.013 and an R2 of 63±19%, where the best-achieved performance was an error level with a normalized mean squared error of 0.008 and an R2 up to 92%. The results are encouraging for remote cardiovascular rehabilitation programs because these models could support the prioritization of remote patients needing more help to succeed in the current rehabilitation phase.
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Cruz-Cobo C, Bernal-Jiménez MÁ, Vázquez-García R, Santi-Cano MJ. Effectiveness of mHealth Interventions in the Control of Lifestyle and Cardiovascular Risk Factors in Patients After a Coronary Event: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2022; 10:e39593. [PMID: 36459396 PMCID: PMC9758644 DOI: 10.2196/39593] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/13/2022] [Accepted: 10/11/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Coronary artery disease is the main cause of death and loss of disability-adjusted life years worldwide. Information and communication technology has become an important part of health care systems, including the innovative cardiac rehabilitation services through mobile phone and mobile health (mHealth) interventions. OBJECTIVE In this study, we aimed to determine the effectiveness of different kinds of mHealth programs in changing lifestyle behavior, promoting adherence to treatment, and controlling modifiable cardiovascular risk factors and psychosocial outcomes in patients who have experienced a coronary event. METHODS A systematic review of the literature was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A thorough search of the following biomedical databases was conducted: PubMed, Embase, Web of Science, SciELO, CINAHL, Scopus, The Clinical Trial, and Cochrane. Articles that were randomized clinical trials that involved an intervention consisting of an mHealth program using a mobile app in patients after a coronary event were included. The articles analyzed some of the following variables as outcome variables: changes in lifestyle behavior, cardiovascular risk factors, and anthropometric and psychosocial variables. A meta-analysis of the variables studied was performed with the Cochrane tool. The risk of bias was assessed using the Cochrane Collaboration tool; the quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation tool; and heterogeneity was measured using the I2 test. RESULTS A total of 23 articles were included in the review, and 20 (87%) were included in the meta-analysis, with a total sample size of 4535 patients. Exercise capacity measured using the 6-minute walk test (mean difference=21.64, 95% CI 12.72-30.55; P<.001), physical activity (standardized mean difference [SMD]=0.42, 95% CI 0.04-0.81; P=.03), and adherence to treatment (risk difference=0.19, 95% CI 0.11-0.28; P<.001) were significantly superior in the mHealth group. Furthermore, both the physical and mental dimensions of quality of life were better in the mHealth group (SMD=0.26, 95% CI 0.09-0.44; P=.004 and SMD=0.27, 95% CI 0.06-0.47; P=.01, respectively). In addition, hospital readmissions for all causes and cardiovascular causes were statistically higher in the control group than in the mHealth group (SMD=-0.03, 95% CI -0.05 to -0.00; P=.04 vs SMD=-0.04, 95% CI -0.07 to -0.00; P=.05). CONCLUSIONS mHealth technology has a positive effect on patients who have experienced a coronary event in terms of their exercise capacity, physical activity, adherence to medication, and physical and mental quality of life, as well as readmissions for all causes and cardiovascular causes. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42022299931; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299931.
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Affiliation(s)
- Celia Cruz-Cobo
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), Cádiz, Spain
- Research Group on Nutrition, Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), Cádiz, Spain
- Research Group on Nutrition, Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), Cádiz, Spain
- Cardiology Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), Cádiz, Spain
- Research Group on Nutrition, Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
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Deng L, Wu Q, Ding F, Liu Y, Shen J, Lin Y, Shi K, Zeng B, Wu L, Tong H. The effect of telemedicine on secondary prevention of atherosclerotic cardiovascular disease: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:1020744. [PMID: 36440018 PMCID: PMC9683074 DOI: 10.3389/fcvm.2022.1020744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
AimThe purpose of this systematic review was to evaluate the efficiency of telemedicine on the secondary level of prevention of patients with arteriosclerotic cardiovascular disease (ASCVD), provide evidence for the application of telemedicine in secondary prevention and promote the development of telemedicine in secondary prevention.MethodsA computer-based search was conducted in MEDLINE, Embase, Pubmed, EBSCO, CINAHL, the Cochrane Library, and Web of Science. Randomized controlled trials regarding the effect of telemedicine on secondary prevention of ASCVD were included from inception to May, 2022. Meta-analysis was used to compare the results of the included studies by RevMan5.4 software. The Cochrane Collaboration bias risk tool was used to perform risk of bias assessment in this study. Outcomes included risk factors, physical activity and exercise, muscle function, exercise compliance, medication adherence, healthy diet, depression and anxiety, self-efficacy, knowledge score, economy, and safety endpoints. Subgroup analysis was carried out for different main intervention measures included in the literature.ResultsA total of 32 randomized clinical studies (n = 10 997 participants) were included in the meta-analysis. Compared with usual secondary prevention (USP) group, participants in telemedicine of secondary prevention (TOSP) group showed significant improvement in some risk factors including BMI (MD –0.87, p = 0.002), SBP (MD –4.09, p = 0.007) and DBP (MD –2.91, p = 0.0002) when they use the telephone as the intervention. In physical activity and exercise, Patients in TOSP showed an improvement in VO2 Peak (mL⋅kg–1⋅min–1) (OR 1.58, p = 0.02), 6MWT (MD 21.41, p = 0.001), GSLTPA score (MD 2.89, p = 0.005). Effects on medication adherence, exercise compliance, muscle function, healthy diet, economy and self-efficacy were synthesized narratively. Patients in TOSP did not show a reduction in knowledge score, depression, anxiety and safety endpoints.ConclusionThere is a net benefit of secondary prevention supported by telemedicine (especially when using the telephone as an intervention) in patients with ASCVD in the terms of some risk factors, physical activity and exercise. There are still controversies in the improvement of medication adherence, exercise compliance, muscle function, healthy diet, knowledge score, self-efficacy and economy via telemedicine, which is worth exploring. Larger samples size and longer-term follow-ups are needed in future studies.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=330478], identifier [CRD42022330478].
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Freak‐Poli R, Phyo AZZ, Hu J, Barker SF. Are social isolation, lack of social support or loneliness risk factors for cardiovascular disease in Australia and New Zealand? A systematic review and meta-analysis. Health Promot J Austr 2022; 33 Suppl 1:278-315. [PMID: 35263481 PMCID: PMC9790538 DOI: 10.1002/hpja.592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/18/2022] [Accepted: 02/24/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An international systematic review concluded that individuals with poor social health (social isolation, lack of social support or loneliness) are 30% more likely to develop coronary heart disease (CHD) and stroke. Notably, the two included Australian papers reported no association between social health and CHD or stroke. OBJECTIVE We undertook a systematic review and meta-analysis to investigate the association between social isolation, lack of social support and loneliness and cardiovascular disease (CVD) incidence among people living in Australia and New Zealand. METHODS Four electronic databases were systematically searched for longitudinal studies published until June 2020. Two reviewers undertook title/abstract screen and one reviewer undertook full-text screen and data extraction. Quality was assessed using the Newcastle - Ottawa Quality Assessment Scale. RESULTS Of the 725 unique records retrieved, five papers met our inclusion criteria. These papers reported data from three Australian longitudinal datasets, with a total of 2137 CHD and 590 stroke events recorded over follow-up periods ranging from 3 to 16 years. Reports of two CHD and two stroke outcomes were suitable for meta-analysis. The included papers reported no association between social health and incidence of CVD in all fully adjusted models and most unadjusted models. CONCLUSIONS Our systematic review is inconclusive as it identified only a few studies, which relied heavily on self-reported CVD. Further studies using medical diagnosis of CVD, and assessing the potential influence of residential remoteness, are needed to better understand the relationship between social health and CVD incidence in Australia and New Zealand.
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Affiliation(s)
- Rosanne Freak‐Poli
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - Jessie Hu
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
| | - S. Fiona Barker
- Department of Epidemiology and Preventive MedicineSchool of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
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10
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Lavoie A, Dubé V. Web-Based Interventions to Promote Healthy Lifestyles for Older Adults: Scoping Review. Interact J Med Res 2022; 11:e37315. [PMID: 35998024 PMCID: PMC9449830 DOI: 10.2196/37315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/14/2022] [Accepted: 08/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background With the aging of the population and rising rates of chronic diseases, web-based interventions could be considered to support older adults in adopting healthy lifestyles. To date, published knowledge syntheses have focused on quantitative studies among older adults aged ≥50 years. However, those aged ≥65 years may have different needs to be met by these interventions because of the biological and physiological changes associated with aging, and qualitative studies could help advance knowledge in this field. Objective The objective of this scoping review is to explore the extent of the literature on web-based interventions aimed at promoting healthy lifestyles among people aged ≥65 years. Methods A scoping review was conducted based on the framework proposed by Levac et al. Six databases (ie, MEDLINE, CINAHL, PsycINFO, Web of Science, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Library) and gray literature (ie, Google Scholar and OpenGrey) were searched. The final search was conducted on June 23, 2021. The studies were selected by 2 persons (AL and ML) independently. The included studies were systematic reviews and qualitative and quantitative studies focusing on web-based interventions to promote healthy lifestyles in people aged ≥65 years that were published in French or English between 1990 and 2021. Data were extracted in a table and synthesized based on the conceptualization of web-based interventions (ie, according to the use parameters, behavior change techniques, delivery modes, and theories). A thematic analysis was performed. Results In total, 20 articles were included in this review, which represents studies focused on 11 distinct interventions. All of the interventions (11/11, 100%) aimed to promote physical activity among older adults. The number of intervention sessions varied from 5 to 16, with a frequency from daily to once every 2 weeks. Diverse delivery modes such as electronic diary, video, and phone call were found. The most used behavior change techniques were instruction, feedback, and self-monitoring. Few interventions (6/11, 55%) were based on a theory. A favorable trend was observed in increasing physical activity, and 5 themes emerged that appeared to be central to behavior change among older adults: motivation, support, tailoring, barriers, and perceptions. Conclusions This scoping review provides a better understanding of the components of web-based interventions and their outcomes on the healthy lifestyles of people aged ≥65 years. These findings could provide important guidance for the design and development of future web-based interventions in this field. Further research is needed to continue the development and evaluation of innovative and accessible interventions to promote healthy lifestyles among older adults. International Registered Report Identifier (IRRID) RR2-10.2196/23207
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Affiliation(s)
- Audrey Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Université de Montréal Marguerite-d'Youville Research Chair on Humanistic Nursing Interventions, Montreal, QC, Canada.,Research center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Université de Montréal Marguerite-d'Youville Research Chair on Humanistic Nursing Interventions, Montreal, QC, Canada.,Research center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
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11
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Vanzella LM, Ghisi GLDM, Colella TJF, Larkin J, Vanderlei LCM, Marzolini S, Thomas S, Oh P. Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study. J Clin Med 2022; 11:4838. [PMID: 36013076 PMCID: PMC9409687 DOI: 10.3390/jcm11164838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p > 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients’ exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR.
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Affiliation(s)
- Lais Manata Vanzella
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
| | | | - Tracey Jacqueline Fitchett Colella
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Jillian Larkin
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | | | - Susan Marzolini
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | - Scott Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada
| | - Paul Oh
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada
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12
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Champion S, Clark RA, Tirimacco R, Tideman P, Gebremichael L, Beleigoli A. The Impact of the SARS-CoV-2 Virus (COVID-19) Pandemic and the Rapid Adoption of Telehealth for Cardiac Rehabilitation and Secondary Prevention Programs in Rural and Remote Australia: A Multi-Method Study. Heart Lung Circ 2022; 31:1504-1512. [PMID: 35987722 PMCID: PMC9384540 DOI: 10.1016/j.hlc.2022.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Centre-based cardiac rehabilitation (CR) programs were disrupted and urged to adopt telehealth modes of delivery during the COVID-19 public health emergency. Previously established telehealth services may have faced increased demand. This study aimed to investigate a) the impact of the COVID-19 pandemic on CR attendance/completion, b) clinical outcomes of patients with cardiovascular (CV) diseases referred to CR and, c) how regional and rural centre-based services converted to a telehealth delivery during this time. METHODS A cohort of patients living in regional and rural Australia, referred to an established telehealth-based or centre-based CR services during COVID-19 first wave, were prospectively followed-up, for ≥90 days (February to June 2020). Cardiac rehabilitation attendance/completion and a composite of CV re-admissions and deaths were compared to a historical control group referred in the same period in 2019. The impact of mode of delivery (established telehealth service versus centre-based CR) was analysed through a competitive risk model. The adaption of centre-based CR services to telehealth was assessed via a cross-sectional survey. RESULTS 1,954 patients (1,032 referred during COVID-19 and 922 pre-COVID-19) were followed-up for 161 (interquartile range 123-202) days. Mean age was 68 (standard deviation 13) years and 68% were male. Referrals to the established telehealth program did not differ during (24%) and pre-COVID-19 (23%). Although all 10 centre-based services surveyed adopted telehealth, attendance (46.6% vs 59.9%; p<0.001) and completion (42.4% vs 75.4%; p<0.001) was significantly lower during COVID-19. Referral during vs pre-COVID-19 (sub hazard ratio [SHR] 0.77; 95% CI 0.68-0.87), and to a centre-based program compared to the established telehealth service (SHR 0.66; 95% CI 0.58-0.76) decreased the likelihood of CR uptake. DISCUSSION An established telehealth service and rapid adoption of telehealth by centre-based programs enabled access to CR in regional and rural Australia during COVID-19. However, further development of the newly implemented telehealth models is needed to promote CR attendance and completion.
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Affiliation(s)
- Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Rosy Tirimacco
- Integrated Cardiovascular Clinical Network SA, Rural and Remote Support Services, SA Department of Health, Adelaide, SA, Australia
| | - Philip Tideman
- Integrated Cardiovascular Clinical Network SA, Rural and Remote Support Services, SA Department of Health, Adelaide, SA, Australia
| | - Lemlem Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
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13
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Lourens EC, Baker RA, Krieg BM. Quality of life following cardiac rehabilitation in cardiac surgery patients. J Cardiothorac Surg 2022; 17:137. [PMID: 35642068 PMCID: PMC9153224 DOI: 10.1186/s13019-022-01893-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undergoing cardiac surgery often result in perioperative loss of health-related quality of life (HRQOL). Although participation rates in Australia is low, cardiac rehabilitation (CR) has been demonstrated to improve patient HRQOL in cardiac patients. Literature is unclear regarding the role of CR and HRQOL in the cardiac surgery (CS) patient population. METHODS A prospective non-randomised study was conducted on eligible cardiac surgery patients between December 2009 and March 2015. HRQOL was assessed using the Short Form 12 at baseline and post-operatively at 30 days and 180 days. CR participation was recorded and barriers to CR uptake was assessed using the Cardiac Rehabilitation Enrolment Obstacles (CREO) scale. RESULTS At 180 days, 107 patients participated in CR and 111 did not participate in CR. A significant improvement from baseline mental and physical HRQOL was observed in both groups at 30 days and 180 days (p < 0.002). No significant difference between group characteristics or HRQOL was observed at any time. A trend of superior improvement in mental QOL was observed in the CR group. The study is limited by poor initial uptake (218/1772 of eligible) and may be underpowered to observe a clinical difference. A significant difference in CREO scores were observed between the two groups at 30 days (13 out of 16 questions, p < 0.001) and 180 days (11 out of 16 questions, p < 0.011). CONCLUSION Literature has shown that CR may improve numerous health outcomes in cardiac and CS patients, however CR uptake in Australia is low. Mental and Physical QOL is demonstrated to improve following CS, however further research is required to delineate the role of CR and QOL in CS patients. The CREO tool utilised in this study identified numerous potentially modifiable barriers to CR uptake. Specific strategies related to the survey are suggested to improve awareness, uptake, and adherence to CR, including advocacy of home-based and telehealth services.
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Affiliation(s)
- Ernest Christian Lourens
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia.
| | - Robert Ashley Baker
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia
| | - Bronwyn M Krieg
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia
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14
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Redfern J, Gallagher R, O’Neil A, Grace SL, Bauman A, Jennings G, Brieger D, Briffa T. Historical Context of Cardiac Rehabilitation: Learning From the Past to Move to the Future. Front Cardiovasc Med 2022; 9:842567. [PMID: 35571195 PMCID: PMC9091441 DOI: 10.3389/fcvm.2022.842567] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
Contemporary myocardial infarction (MI) care and management has evolved dramatically since the 1950's; yet outpatient rehabilitation remains underutilized. Deepening our understanding of the origins and history of cardiac rehabilitation highlights a contemporary shift required for policy and practice related to secondary prevention of coronary disease in light of societal changes as well as medical, digital and surgical advancements. Contemporary "cardiac rehabilitation" began when bed rest and physical inactivity was recommended and commonplace for MI survivors. Today, most patients who survive an MI, undergo reperfusion therapy, a short inpatient stay and are discharged with minimal physical morbidity. Despite this, the majority of modern day programs continue to be structured in the same way they have been for the past 50 years and this model has become incongruent with the contemporary context, especially in the COVID-19 era. This review aims to describe the historical foundations of cardiac rehabilitation to inform solutions and meet the demands of contemporary MI management. Delivering health systems reform to address modernization is current healthcare challenge where a united and interdisciplinary effort is needed.
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Affiliation(s)
- Julie Redfern
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adrienne O’Neil
- School of Medicine, IMPACT Institute, Deakin University, Geelong, VIC, Australia
| | - Sherry L. Grace
- Faculty of Health, York University, Toronto, ON, Canada
- KITE Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Adrian Bauman
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Garry Jennings
- National Heart Foundation of Australia, Melbourne, VIC, Australia
| | - David Brieger
- Department of Cardiology, Concord Hospital, Sydney, NSW, Australia
| | - Tom Briffa
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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15
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Beleigoli A, Nicholls SJ, Brown A, Chew DP, Beltrame J, Maeder A, Maher C, Versace VL, Hendriks JM, Tideman P, Kaambwa B, Zeitz C, Prichard IJ, Tavella R, Tirimacco R, Keech W, Astley C, Govin K, Nesbitt K, Du H, Champion S, Pinero de Plaza MA, Lynch I, Poulsen V, Ludlow M, Wanguhu K, Meyer H, Krollig A, Gebremichael L, Green C, Clark RA. Implementation and prospective evaluation of the Country Heart Attack Prevention model of care to improve attendance and completion of cardiac rehabilitation for patients with cardiovascular diseases living in rural Australia: a study protocol. BMJ Open 2022; 12:e054558. [PMID: 35173003 PMCID: PMC8852732 DOI: 10.1136/bmjopen-2021-054558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Despite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%-50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants. METHODS AND ANALYSIS CHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation. ETHICS AND DISSEMINATION This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver of informed consent. Findings and dissemination to patients and clinicians will be through a public website, online educational sessions and scientific publications. Deidentified data will be available from the corresponding author on reasonable request. TRIAL REGISTRATION NUMBER ACTRN12621000222842.
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Affiliation(s)
- Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
| | - Alex Brown
- Indigenous Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Derek P Chew
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - John Beltrame
- The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anthony Maeder
- Flinders Digital Health Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Deakin University, Melbourne, Victoria, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Philip Tideman
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Integrated Cardiovascular Clinical Network, Rural Support Service, Adelaide, South Australia, Australia
| | - Billingsley Kaambwa
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Christopher Zeitz
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ivanka J Prichard
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Rosanna Tavella
- The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rosy Tirimacco
- Integrated Cardiovascular Clinical Network, Rural Support Service, Adelaide, South Australia, Australia
| | - Wendy Keech
- Health Translation SA, Adelaide, South Australia, Australia
| | - Carolyn Astley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kay Govin
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Huiyun Du
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Imelda Lynch
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Vanessa Poulsen
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Marie Ludlow
- National Heart Foundation of Australia, Mawson, Australia Central Territory, Australia
| | - Ken Wanguhu
- Royal Australian College of General Practitioners, Waikerie, Victoria, Australia
| | - Hendrika Meyer
- Rural Support Service, SA Health, Adelaide, South Australia, Australia
| | - Ali Krollig
- Rural Support Service, SA Health, Adelaide, South Australia, Australia
| | - Lemlem Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Chloe Green
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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16
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Rivers JT, Smith C, Smith I, Cameron J. The Impact of a Mobile App on Participation in Cardiac Rehabilitation and Understanding Barriers to Success: Comparative Cohort Study. JMIR Cardio 2022; 6:e24174. [PMID: 35037891 PMCID: PMC8804955 DOI: 10.2196/24174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/23/2020] [Accepted: 11/30/2021] [Indexed: 11/29/2022] Open
Abstract
Background Poor patient uptake of cardiac rehabilitation (CR) remains a challenge for multiple reasons including geographic, time, cultural, cost, and psychological constraints. Objective We evaluated the impact on CR participation rates associated with the addition of the option of mobile app–based CR (Cardihab) for patients declining conventional CR. Methods A total of 204 consecutive patients were offered CR following angioplasty; of these, 99 were in cohort 1 (offered conventional CR only) and 105 were in cohort 2 (app-based CR offered to those declining conventional CR). Patients in each cohort were followed throughout a 6-week CR program and participation rates were compared for both groups. Patients in cohort 2 declining both forms of CR were interviewed to assess reasons for nonparticipation. Results CR participation improved from 21% (95% CI 14%-30%) to 63% (95% CI 53%-71%) with the addition of the app (P<.001). Approximately 25% (9/39) of the group declining the app-based program identified technology issues as the reason for nonparticipation. The remainder declined both CR programs or were ineligible due to frailty or comorbidities. Conclusions Providing patients with the additional option of an app-based CR program substantially improved CR participation. Technology and psychological barriers can limit CR participation. Further innovation in CR delivery systems is required to improve uptake.
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Affiliation(s)
- John T Rivers
- Queensland Cardiovascular Group, St Andrew's Specialist Centre, Brisbane, Australia.,St Andrew's War Memorial Hospital, Brisbane, Australia.,St Vincent's Private Hospital Northside, Brisbane, Australia
| | - Carla Smith
- Queensland Cardiovascular Group, St Andrew's Specialist Centre, Brisbane, Australia
| | - Ian Smith
- St Andrew's War Memorial Hospital, Brisbane, Australia
| | - James Cameron
- Queensland Cardiovascular Group, St Andrew's Specialist Centre, Brisbane, Australia.,St Andrew's War Memorial Hospital, Brisbane, Australia
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17
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Gregory AT, Denniss AR. Heart, Lung and Circulation in the COVID-19 Era: About COVID-19, Not Just About COVID-19. Heart Lung Circ 2021; 30:1792-1799. [PMID: 34742544 PMCID: PMC8563592 DOI: 10.1016/j.hlc.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - A Robert Denniss
- Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, and University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Blacktown Hospital, and Western Sydney University, Sydney, NSW, Australia.
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18
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Ogura A, Izawa KP, Tawa H, Kureha F, Wada M, Harada N, Ikeda Y, Kimura K, Kondo N, Kanai M, Kubo I, Yoshikawa R, Matsuda Y. Older phase 2 cardiac rehabilitation patients engaged in gardening maintained physical function during the COVID-19 pandemic. Heart Vessels 2021; 37:77-82. [PMID: 34152441 PMCID: PMC8215626 DOI: 10.1007/s00380-021-01892-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/11/2021] [Indexed: 01/09/2023]
Abstract
This study aimed to clarify the effects of gardening on hemodynamic response, rating of perceived exertion (RPE) during exercise, and body weight in patients in whom phase 2 cardiac rehabilitation (CR) was interrupted due to the Coronavirus disease 2019 (COVID-19) pandemic. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. Patients under the age of 65 were excluded. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the gardener group and the non-gardener group. Forty-one patients were enrolled in the final analysis. After CR interruption, the gardener group did not show any significant difference in all items, whereas the non-gardener group experienced significant increase in HR (Peak) (p = 0.004) and worsening of the Borg scale scores for both dyspnea and lower extremity fatigue (p = 0.039 and p = 0.009, respectively). Older phase 2 CR patients engaged in gardening did not show any deterioration in hemodynamic response or RPE during exercise, despite CR interruption and refraining from going outside. Gardening may be recommended as one of the activities that can maintain or improve physical function in older phase 2 CR patients during the COVID-19 pandemic.
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Affiliation(s)
- Asami Ogura
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan.
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Fumie Kureha
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Masaaki Wada
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
| | - Nobuko Harada
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Yuki Ikeda
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Kaemi Kimura
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Naomi Kondo
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Masashi Kanai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | | | - Yuichi Matsuda
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
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19
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Astley CM, Clarke RA, Cartledge S, Beleigoli A, Du H, Gallagher C, Millington S, Hendriks JM. Remote cardiac rehabilitation services and the digital divide: implications for elderly populations during the COVID19 pandemic. Eur J Cardiovasc Nurs 2021; 20:521-523. [PMID: 34056650 PMCID: PMC8195107 DOI: 10.1093/eurjcn/zvab034] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Carolyn M Astley
- Flinders University, College of Nursing and Health Sciences, Sturt Campus, University Drive, Bedford Park 5042, Australia
| | - Robyn A Clarke
- Flinders University, College of Nursing and Health Sciences, Sturt Campus, University Drive, Bedford Park 5042, Australia
| | - Susie Cartledge
- Monash University, School of Public Health, St Kilda Road, Melbourne 3004, Australia
| | - Alline Beleigoli
- Flinders University, College of Nursing and Health Sciences, Sturt Campus, University Drive, Bedford Park 5042, Australia
| | - Huiyun Du
- Flinders University, College of Nursing and Health Sciences, Sturt Campus, University Drive, Bedford Park 5042, Australia
| | - Celine Gallagher
- University Adelaide, Centre for Heart Rhythm Disorders, North Tce, Adelaide 5005, Australia.,Department of Cardiology, Royal Adelaide Hospital, North Tce, Adelaide 5000, Australia
| | - Sindy Millington
- University Adelaide, Centre for Heart Rhythm Disorders, North Tce, Adelaide 5005, Australia
| | - Jeroen M Hendriks
- Flinders University, College of Nursing and Health Sciences, Sturt Campus, University Drive, Bedford Park 5042, Australia.,University Adelaide, Centre for Heart Rhythm Disorders, North Tce, Adelaide 5005, Australia.,Department of Cardiology, Royal Adelaide Hospital, North Tce, Adelaide 5000, Australia
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20
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Zobeck B, Carson E, MacDowell M, Hunt A, Reeder A. Appointment attendance and patient perception of drive-up INR testing in a rural anticoagulation clinic during the COVID-19 pandemic. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021; 4:459-464. [PMID: 33821238 PMCID: PMC8014677 DOI: 10.1002/jac5.1390] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 04/11/2023]
Abstract
INTRODUCTION The Anticoagulation Forum and Centers for Disease Control and Prevention (CDC) recommend drive-up international normalized ratio (INR) testing to combat INR non-adherence and increase safety during the coronavirus disease 2019 (COVID-19) pandemic. Patient perceptions and impact on attendance have not been studied. OBJECTIVE To assess appointment volume and patient perception after initiation of drive-up INR testing in a rural pharmacist-managed anticoagulation clinic. METHODS This cross-sectional cohort survey study offered each patient attending the anticoagulation clinic via drive-up or in-office visit a survey between May 27 and July 2, 2020. Patients testing off-site were excluded. Study end points included monthly patient volume, visit type preference, testing barriers, desired drive-up duration, and overall clinic satisfaction. Clinic appointment volume from October 2019 to June 2020 was collected retrospectively through a schedule review. RESULTS Sixty-four (80%) of 80 surveys offered were completed: 46.6% of respondents preferred drive-up testing, 26.7% indifferent, and 26.7% preferred in-office visits; 38.7% of respondents indicated a greater likelihood of continuing routine INR monitoring via drive-up testing. Of the respondents completing the survey curbside, 46% and 27% of respondents identified reduced COVID-19 transmission risk and ease of transportation as benefits of drive-up INR testing, respectively. March and April clinic volumes were 19% and 22% below average, respectively, returning to baseline after drive-up testing was implemented. Clinic rating before and after drive-up testing remained high at 2.75 on a scale of 0-3. While infection risk was identified as the biggest barrier to care by 32.8% of respondents, 59.3% of all respondents wanted drive-up testing to continue indefinitely. CONCLUSIONS Drive-up INR testing improves patient attendance during the COVID-19 pandemic. Patient perception of drive-up testing is positive. About 46% of respondents preferred drive-up INR testing with telehealth follow-up and 59.3% of respondents want drive-up testing to continue indefinitely, which suggests this approach to INR testing as a potential method to allay barriers to routine monitoring beyond the scope of the pandemic.
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Affiliation(s)
- Bryan Zobeck
- University of Illinois Chicago College of PharmacyDixonIllinoisUSA
| | - Erin Carson
- University of Illinois Chicago College of Pharmacy/SwedishAmerican Health SystemRockfordIllinoisUSA
| | - Martin MacDowell
- University of Illinois Dept. Family Medicine – National Center for Rural Health Professions and Dept. of Pharmacy Administration, College of PharmacyRockfordIllinoisUSA
| | - Aaron Hunt
- University of Illinois Chicago College of PharmacyRockfordIllinoisUSA
| | - Austin Reeder
- University of Illinois Chicago College of PharmacyRockfordIllinoisUSA
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21
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Aragaki D, Luo J, Weiner E, Zhang G, Darvish B. Cardiopulmonary Telerehabilitation. Phys Med Rehabil Clin N Am 2021; 32:263-276. [PMID: 33814057 DOI: 10.1016/j.pmr.2021.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cardiopulmonary telerehabilitation is a safe and effective alternative to traditional center-based rehabilitation. It offers a sustainable solution to more conveniently meet the needs of patients with acute or chronic, preexisting or newly acquired, cardiopulmonary diseases. To maximize success, programs should prioritize basic, safe, and timely care options over comprehensive or complex approaches. The future should incorporate new strategies learned during a global pandemic and harness the power of information and communication technology to provide evidence-based patient-centered care. This review highlights clinical considerations, current evidence, recommendations, and future directions of cardiopulmonary telerehabilitation.
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Affiliation(s)
- Dixie Aragaki
- Department of Medicine, Division of Physical Medicine and Rehabilitation, David Geffen School of Medicine at UCLA, Los Angeles, CA USA; Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (117), Los Angeles, CA 90073, USA.
| | - Jerry Luo
- Physical Medicine and Rehabilitation Residency (PGY-2), Greater Los Angeles VA Healthcare System, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard (117), Los Angeles, CA 90073, USA
| | - Elizabeth Weiner
- Physical Medicine and Rehabilitation Residency (PGY-2), Greater Los Angeles VA Healthcare System, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard (117), Los Angeles, CA 90073, USA
| | - Grace Zhang
- Physical Medicine and Rehabilitation Residency (PGY-2), Greater Los Angeles VA Healthcare System, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard (117), Los Angeles, CA 90073, USA
| | - Babak Darvish
- Cardiopulmonary Telehealth Service, Physical Medicine and Rehabilitation Service, Greater Los Angeles Healthcare System, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard (117), Los Angeles, CA 90073, USA
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22
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Bitar H, Alismail S. The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review. Digit Health 2021; 7:20552076211009396. [PMID: 33959378 PMCID: PMC8060773 DOI: 10.1177/20552076211009396] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 03/20/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To summarize the current status of, and the current expert opinions, recommendation and evidence associated with the use and implementation of electronic health (eHealth), telemedicine, and/or telehealth to provide healthcare services for chronic disease patients during the COVID-19 pandemic. MATERIALS AND METHODS We searched four electronic databases (PubMed, Google Scholar, Science Direct, and Web of Science Core Collection) to identify relevant articles published between 2019 and 2020. Searches were restricted to English language articles only. Two independent reviewers screened the titles, abstracts, and keywords for relevance. The potential eligible articles, papers with no abstract, and those that fall into the uncertain category were read in full text independently. The reviewers met and discussed which articles to include in the final review and reached a consensus. RESULTS We identified 51 articles of which 25 articles met the inclusion criteria. All included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine solutions in delivering healthcare services to patients living with chronic diseases/conditions during the COVID-19 pandemic. We synthesized the main findings into ten usages and eight recommendations concerning the different activities for delivering healthcare services remotely for those living with chronic diseases/conditions in the era of COVID-19. DISCUSSION AND CONCLUSIONS There is limited evidence available about the effectiveness of such solutions. Further research is required during this pandemic to improve the credibility of evidence on telemedicine, telehealth, and/or eHealth-related outcomes for those living with chronic diseases.
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Affiliation(s)
- Hind Bitar
- Department of Information Systems, King Abdulaziz University,
Jeddah, Saudi Arabia
| | - Sarah Alismail
- Center for Information Systems & Technology, Claremont
Graduate University, Claremont, USA
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23
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Gregory AT, Pepe S, Denniss AR. COVID-19 and Heart, Lung and Circulation: Riding the 2020 Waves of Change in Australia & New Zealand ✰. Heart Lung Circ 2020; 29:1737-1740. [PMID: 33218388 PMCID: PMC7834382 DOI: 10.1016/j.hlc.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Ann T Gregory
- Heart, Lung and Circulation, Sydney, NSW, Australia.
| | - Salvatore Pepe
- Heart, Lung and Circulation, Sydney, NSW, Australia; Murdoch Children's Research Institute; Department of Cardiology, Royal Children's Hospital; Department of Paediatrics, University of Melbourne, Vic, Australia
| | - A Robert Denniss
- Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, and University of Sydney, NSW, Australia; Department of Cardiology, Blacktown Hospital, and Western Sydney University, NSW, Australia
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24
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Ferguson C, Inglis SC, Gallagher R, Davidson PM. Reflecting on the Impact of Cardiovascular Nurses in Australia and New Zealand in the International Year of the Nurse and Midwife. Heart Lung Circ 2020; 29:1744-1748. [PMID: 33067125 PMCID: PMC7553902 DOI: 10.1016/j.hlc.2020.09.921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District & Western Sydney University, Blacktown Hospital, Sydney, NSW, Australia.
| | - Sally C Inglis
- IMPACCT and School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Robyn Gallagher
- Charles Perkins Centre & Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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25
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Inglis SC, Naismith C, White K, Hendriks JM, Bray J, Hickman LD, Aldridge C, Bardsley K, Cameron J, Candelaria D, Cartledge S, Du H, Ferguson C, Martin L, Selkow T, Xu X, Wynne R, Driscoll A, Gallagher R, Clark R, Davidson PM. CSANZ COVID-19 Cardiovascular Nursing Care Consensus Statement: Executive Summary. Heart Lung Circ 2020; 29:1263-1267. [PMID: 32859539 PMCID: PMC7413197 DOI: 10.1016/j.hlc.2020.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sally C Inglis
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Carolyn Naismith
- Department of Cardiology, Austin Health, Melbourne, Vic, Australia
| | | | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University; Centre for Heart Rhythm Disorders, University of Adelaide; Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Janet Bray
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Louise D Hickman
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Chris Aldridge
- Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | | | - Jan Cameron
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Dion Candelaria
- Susan Wakil School of Nursing and Midwifery, & Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Susie Cartledge
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Huiyun Du
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia
| | - Lorelle Martin
- Department of Cardiology, Austin Health, Melbourne, Vic, Australia
| | | | - Xiaoyue Xu
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia; Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia; Department of Cardiology, Austin Health, Melbourne, Vic, Australia; Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Robyn Gallagher
- Susan Wakil School of Nursing and Midwifery, & Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Robyn Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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26
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Volpe M, Battistoni A, Bellotti P, Bellone S, Bertolotti M, Biffi A, Consoli A, Corsini A, Desideri G, Ferri C, Modena MG, Nati G, Pirro M, Rubattu S, Tocci G, Trimarco B, Volpe R, de Kreutzenberg SV. Recommendations for Cardiovascular Prevention During the Sars-Cov-2 Pandemic: An Executive Document by the Board of the Italian Society of Cardiovascular Prevention. High Blood Press Cardiovasc Prev 2020; 27:373-377. [PMID: 32734561 PMCID: PMC7391228 DOI: 10.1007/s40292-020-00401-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/21/2020] [Indexed: 12/18/2022] Open
Abstract
In 2020, the Sars-Cov-2 pandemic is causing a huge and dramatic impact on healthcare systems worldwide. During this emergency, fragile patients suffering from other comorbidities, especially patients susceptible to or affected by cardiovascular disease, are the ones most exposed to the poorer outcomes. Therefore, it is still mandatory to continue to strictly adhere to the rules of cardiovascular prevention. This document aims to provide all doctors with simple and clear recommendations in order to spread useful messages to the widest number of subjects in order to continue the battle against cardiovascular diseases even in times of pandemic.
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Affiliation(s)
- Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy. .,IRCCS Neuromed, Pozzilli, Italy.
| | - Allegra Battistoni
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | | | | | | | | | - Alessandro Biffi
- Med-Ex, Medicine and Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | | | | | | | | | | | - Giulio Nati
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Matteo Pirro
- Università degli studi di Perugia, Perugia, Italy
| | - Speranza Rubattu
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Giuliano Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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27
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Dhakal BP, Sweitzer NK, Indik JH, Acharya D, William P. SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart. Heart Lung Circ 2020; 29:973-987. [PMID: 32601020 PMCID: PMC7274628 DOI: 10.1016/j.hlc.2020.05.101] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus disease (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The symptoms of the disease range from asymptomatic to mild respiratory symptoms and even potentially life-threatening cardiovascular and pulmonary complications. Cardiac complications include acute myocardial injury, arrhythmias, cardiogenic shock and even sudden death. Furthermore, drug interactions with COVID-19 therapies may place the patient at risk for arrhythmias, cardiomyopathy and sudden death. In this review, we summarise the cardiac manifestations of COVID-19 infection and propose a simplified algorithm for patient management during the COVID-19 pandemic.
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Affiliation(s)
| | | | - Julia H Indik
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA
| | - Deepak Acharya
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA
| | - Preethi William
- Sarver Heart Center, University of Arizona, Tucson, AZ, USA.
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28
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Robert Denniss A, Chow CK, Kritharides L. Cardiovascular and Logistic Issues Associated With COVID-19 Pandemic. Heart Lung Circ 2020; 29:655-656. [PMID: 32305329 PMCID: PMC7151485 DOI: 10.1016/j.hlc.2020.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- A Robert Denniss
- Editor-in-Chief, Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
| | - Clara K Chow
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; President-Elect, CSANZ
| | - Leonard Kritharides
- Department of Cardiology, Concord Hospital, Sydney, NSW, Australia; President, CSANZ
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