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Gondekar A, Singh VP, Rajan Samuel S, Raghavan H, Khandelwal B, Kumar KV. Knowledge, Attitude, and Practice of Physiotherapists about Cardiac Rehabilitation Program Adherence among Patients Discharged from the Hospital after Cardiac Surgery in India. ScientificWorldJournal 2024; 2024:8825476. [PMID: 38799378 PMCID: PMC11126335 DOI: 10.1155/2024/8825476] [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: 05/26/2023] [Revised: 11/19/2023] [Accepted: 02/15/2024] [Indexed: 05/29/2024] Open
Abstract
Background In most settings, patients receive phase 1 cardiac rehabilitation in CTVS ICU at the hospital, but there are several barriers to follow-up after patients are discharged from the hospital. Physiotherapists play an important role in the enrolment and continuation of cardiac rehabilitation. Thus, we aim to study the knowledge, attitude, and practice of physiotherapists about CR program adherence among patients discharged from the hospital after cardiac surgery. Objectives (i) To study the knowledge of physiotherapists about the importance of cardiac rehabilitation after discharge; (ii) to know the attitude of physiotherapists towards cardiac surgery patients after discharge; and (iii) to know what approach various centres are applying for patients after discharge to ensure adherence to cardiac rehabilitation. Methods A questionnaire was developed with reference to the objectives of the study, which was answered by a total of 127 physiotherapists. Results The overall response rate was 42.3%; nearly 35.4% of the participants indicated that they knew a lot about CR, while 5.5% said they knew very little. Regarding the program's content, 36.2% of participants reported having a medium degree of awareness of the diverse CR components, while 8.6% reported having very little knowledge of them. Only about one-third, 35.7% stated that CR in India is effective and 95% believed that CR will have an added value for the country. Approximately 80% of respondents thought that it would be challenging for a physiotherapist to recommend patients to a CR in the nation. Nearly 35% of respondents believed that they, "themselves as physios," needed to commence CR, and slightly less than 70% thought that doctors were required to choose and refer the patients when asked who should take the initiative to start this kind of programme in the country. A little over 40% of respondents said that insurance firms are also involved in starting a CR programme. Conclusion Physiotherapists have good knowledge of cardiac rehabilitation. However, their attitude and practice towards adherence to exercise protocols are confounded by various clinician- and patient-level factors.
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Affiliation(s)
- Ayman Gondekar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
- Manipal Academy of Higher Education, Manipal, India
| | - Vijay Pratap Singh
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
- Manipal Academy of Higher Education, Manipal, India
| | - Stephen Rajan Samuel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
- Manipal Academy of Higher Education, Manipal, India
| | - Harish Raghavan
- Cardiothoracic and Vascular Surgeon, Kasturba Medical College Hospital, Mangalore, India
| | - Bidita Khandelwal
- Department of Medicine, Sikkim Manipal University, Sikkim Manipal Institute of Medical Sciences, Gangtok, India
| | - K. Vijaya Kumar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
- Manipal Academy of Higher Education, Manipal, India
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Boggess K, Hayes E, Duffy ML, Indranoi C, Sorey AB, Blaine T, McKeon L. Nurse-Led Cardiac Rehabilitation Care Coordination Program: Improving Functional Outcomes for Patients Through Automatic Referral and Effective Care Coordination. J Cardiopulm Rehabil Prev 2024; 44:168-173. [PMID: 38502090 DOI: 10.1097/hcr.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
PURPOSE The aim of this investigation was to evaluate the impact of automated cardiac rehabilitation (CR) referral and nurse care coordination on patient and program outcomes. Specifically, the aim was to identify whether differences exist in physical and psychological function at CR Phase 2 enrollment and completion and CR Phase 2 participation and completion for hospitalized patients who receive in-person CR nurse visits versus phone consultation. Using a retrospective pre-/post-intervention descriptive design, a purposive sampling technique was used to select groups with matching clinical attributes. Dates were selected to mitigate the impact of COVID-19 on CR program enrollment and completion. METHODS Data were abstracted from the patient electronic medical record, telemetry documentation, and CR referral tracking tool. Patient descriptors included age, sex, cardiac diagnosis/procedure (post-coronary artery bypass graft surgery, myocardial infarction, percutaneous coronary intervention, heart failure, and aortic valve repair and replacement) and cardiac risk stratification category. Patient functional outcomes included the 6-min walk test and metabolic equivalents of task levels for functional capacity; psychological function was measured by the Patient Health Questionnaire assessment. Program outcomes included discharge to CR Phase 2 enrollment, CR sessions, and completion. RESULTS Each group had 52 patients. Age was 64 ± 12 yr, 68% were male. Perhaps indications for CR included coronary artery bypass graft surgery (44%), myocardial infarction (19%), percutaneous coronary intervention (20%), heart failure (10%), aortic valve repair and replacement (8%). Cardiac risk was low in 30%, intermediate in 65%, and high in 5%. The post-intervention group compared with the pre-intervention group had a shorter discharge to CR Phase 2 enrollment (35 ± 18 d vs 41 ± 28 d, P = .078) and significantly fewer sessions required for CR completion. CONCLUSION Automated CR referral and nurse care coordination visits for hospitalized patients decreased the transition period between CR Phase 1 and 2. Patients were physically and psychologically prepared for earlier CR Phase 2 enrollment and successfully completed the program in fewer days than the pre-intervention group.
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Affiliation(s)
- Kristi Boggess
- Author Affiliations: The University of Tennessee Medical Center, Knoxville (Ms Boggess and Dr McKeon); Heart Lung Vascular Institute, The University of Tennessee Medical Center, Knoxville (Mss Hayes and Duffy); Patient Care Pathways, The University of Tennessee Medical Center, Knoxville (Mr Indranoi); and Cardiovascular and Pulmonary Rehabilitation, The University of Tennessee Medical Center, Knoxville (Mr Sorey). The University of Tennessee Medical Center, Knoxville (Ms Blaine)
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Vonk T, Maessen MFH, Hopman MTE, Snoek JA, Aengevaeren VL, Franklin BA, Eijsvogels TMH, Bakker EA. Temporal Trends in Cardiac Rehabilitation Participation and Its Core Components: A Nationwide Cohort Study From the Netherlands. J Cardiopulm Rehabil Prev 2024; 44:180-186. [PMID: 38373064 DOI: 10.1097/hcr.0000000000000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
PURPOSE Patient- and disease-specific data on cardiac rehabilitation (CR) participation and changes over time are limited. The objective of this study was to describe time trends in CR participation between 2013 and 2019 and provides insights into the utilization of CR components. METHODS Patients with cardiovascular disease (CVD) with an indication for CR were enrolled between 2013 and 2019. Dutch health insurance claims data were used to identify CR participation and its components. RESULTS In total, 106 212 patients with CVD were included of which 37% participated in CR. Participation significantly increased from 28% in 2013 to 41% in 2016 but remained unchanged thereafter. Participation was highest in the youngest age groups (<50 yrs 52%; 50-65 yrs 50%), men (48%), patients with ST-segment elevation myocardial infarction (73%), non-ST-segment elevation myocardial infarction (59%), and coronary artery bypass grafting (82%). In contrast, it was the lowest in the oldest age group (≥85 yrs 8%), women (30%), and in patients with heart failure (11%). Most participants in CR received referral plus an admission session (97%) and exercise training (82%), whereas complementary services related to dietary (14%) and mental health counseling (10%) had a low utilization. CONCLUSIONS CR participation rates increased to 41% in 2016 but remained unchanged thereafter. Participation modulators included age, sex, CVD diagnosis, and undergoing a cardiothoracic procedure. Education and exercise sessions were frequently adopted, but dietary and mental health counseling had a low utilization rate. These findings suggest the need for reinvigorated referral and novel enrollment strategies in specific CVD subgroups to further promote CR participation and its associated underutilized adjunctive services.
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Affiliation(s)
- Thijs Vonk
- Author Affiliations: Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands (Mr Vonk and Drs Hopman, Aengevaeren, Eijsvogels, and Bakker); Customer Intelligence, Coöperatie VGZ, Arnhem, The Netherlands (Dr Maessen); Isala Heart Center, Zwolle, The Netherlands (Dr Snoek); Department of Preventive Cardiology, Beaumont Health & Wellness Center, Royal Oak, Michigan, USA (Dr Franklin); and PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain (Dr Bakker)
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Regan-Moriarty J, Hardcastle S, McCallion M, Youell A, Collery A, McCarren A, Moyna N, Kehoe B. 'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme. PLoS One 2024; 19:e0291700. [PMID: 38551937 PMCID: PMC10980187 DOI: 10.1371/journal.pone.0291700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. AIM To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. METHODS Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. RESULTS Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. CONCLUSION Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.
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Affiliation(s)
- Joanne Regan-Moriarty
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Sarah Hardcastle
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | - Maire McCallion
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Azura Youell
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | | | - Andrew McCarren
- School of Computing, Dublin City University, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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Hollings M, Zhao E, Weddell J, Naismith S, Tofler G, Bauman A, Gallagher R. Lower cardiac rehabilitation enrolment occurs in acute coronary syndrome patients who report low levels of physical activity at four weeks post-event: A prospective observational study using physical activity tracker data. Heart Lung 2024; 64:143-148. [PMID: 38215534 DOI: 10.1016/j.hrtlng.2023.12.007] [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: 09/21/2023] [Revised: 12/19/2023] [Accepted: 12/31/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Physical activity (PA) and cardiac rehabilitation (CR) attendance are important for recovery and prognosis following acute coronary syndrome (ACS). However, PA patterns early post-ACS are not well known. OBJECTIVES Investigate the level of PA at 4-weeks post-ACS and any potential associations with CR enrolment. METHODS We recruited patients admitted for ACS from cardiac wards and clinics at two hospital sites in Sydney, Australia. PA data were collected using wearable activity trackers worn at 4-weeks post-ACS, and CR enrolment was self-reported. RESULTS Participants (n = 61) were aged 66.7 ± 10.3 years, 74 % male, 61 % were married or partnered, and 33 % were diagnosed with ST-elevation myocardial infarction. Patients engaged in 7514±3355 steps per day and 44.6 ± 37.5 min of moderate-to-vigorous physical activity (MVPA). Patients who enrolled in CR exhibited higher daily step counts (p = 0.044), MVPA minutes (p = 0.001), and were more likely to meet PA guidelines. ACS patients who engaged in higher levels of MVPA were more likely to enrol in CR (odds ratio [OR] 1.46; 95 % confidence interval [CI] 1.08, 1.98). CR enrolment was also positively associated with being married or in an intimate partnership (OR 9.93; 95 % CI 1.83, 53.85) and absence of depressive symptoms (OR 11.86; 95 % CI 1.91, 73.74). CONCLUSION Lower CR enrolment rates were observed among less physically active patients at 4-weeks post-ACS. However, each 10 min increment in MVPA increased the odds of CR enrolment by 46 %. Future research should explore strategies to target this inactive and high-risk group, given the potential for a large prognostic gain with CR participation.
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Affiliation(s)
- Matthew Hollings
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia.
| | - Emma Zhao
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Joseph Weddell
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Sharon Naismith
- Charles Perkins Centre, University of Sydney, Australia; Faculty of Science, University of Sydney, Australia
| | - Geoffrey Tofler
- Faculty of Medicine and Health, University of Sydney, Australia; Royal North Shore Hospital, St Leonards, Australia
| | - Adrian Bauman
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia; Royal North Shore Hospital, St Leonards, Australia
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Vanzella LM, Konidis R, Pakosh M, Aultman C, Ghisi GLDM. A Systematic Review of Interventions With an Educational Component Aimed at Increasing Enrollment and Participation in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2024; 44:83-90. [PMID: 37820282 DOI: 10.1097/hcr.0000000000000820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the impact and characteristics of interventions with an educational component designed to improve enrollment and participation in cardiac rehabilitation (CR) among patients with cardiovascular disease. REVIEW METHODS Five electronic databases were searched from data inception to February 2023. Randomized controlled trials and controlled, cohort, and case-control studies were considered for inclusion. Title, abstract, and full text of records were screened by two independent reviewers. The quality of included studies was rated using the Mixed Methods Assessment Tool. Results were analyzed in accordance with the Synthesis Without Meta-analysis reporting guideline. RESULTS From 7601 initial records, 13 studies were included, six of which were randomized controlled trials ("high" quality = 53%). Two studies evaluated interventions with an educational component for health care providers (multidisciplinary team) and 11 evaluated interventions for patient participants (n = 2678). These interventions were delivered in a hybrid (n = 6; 46%), in-person (n = 4; 30%), or virtual (n = 3; 23%) environment, mainly by nurses (n = 4; 30%) via discussion and orientation. Only three studies described the inclusion of printed or electronic materials (eg, pamphlets) to support the education. Eleven of 12 studies reported that patients who participated in interventions with an educational component or were cared for by health care providers who were educated about CR benefits (inhospital and/or after discharge) were more likely to enroll and participate in CR. CONCLUSION Interventions with an educational component for patients or health care providers play an important role in increasing CR enrollment and participation and should be pursued. Studies investigating the effects of such interventions in people from ethnic minority groups and living in low-and-middle-income countries, as well as the development of standard educational materials are recommended.
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Affiliation(s)
- Lais Manata Vanzella
- University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada (Drs Vanzella and Ghisi and Mss Konidis and Aultman); The KITE Research Institute, Toronto, Ontario, Canada (Drs Vanzella and Ghisi); Library & Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada (Ms Pakosh); and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada (Dr Ghisi)
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Valtueña-Gimeno N, Ferrer-Sargues FJ, Fabregat-Andrés O, Martínez-Hurtado I, Martínez-Olmos FJ, Lluesma-Vidal M, Arguisuelas MD. The impact of a neuromuscular rehabilitation programme on the quality of life of patients with acute coronary syndrome and its relationship with sexual dysfunction: a randomised controlled trial. Qual Life Res 2024; 33:433-442. [PMID: 37985639 DOI: 10.1007/s11136-023-03534-7] [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] [Accepted: 09/29/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Many patients with acute coronary syndrome experience problematic or altered sexual function. This aspect of the disease is frequently ignored or overlooked by the healthcare community even though it can strongly influence health-related patient quality of life (HRQoL). Thus, the aim of this study was to compare the effects of a specific cardiac rehabilitation programme focused on aerobic and neuromuscular strength-resistance training to those of a classic rehabilitation programme, both in terms of HRQoL and erectile dysfunction in patients with acute coronary syndrome. METHODS This study reports both secondary and unregistered outcomes from a double-blinded, randomised, and controlled clinical trial. The proposed intervention was based on the completion of a 20-session (10-week) cardiac rehabilitation programme for patients with cardiovascular disease. The patient cohort had been diagnosed with acute coronary syndrome and was recruited at the Cardiology Service of a private tertiary hospital. The outcomes assessed in this study were HRQoL and erectile disfunction assessed at baseline, after the intervention, and at a 6-month follow-up. RESULTS A total of 30 participants were randomly allocated to each study arm. The results of the two-way mixed ANOVAs showed significant group × time interactions for all the outcome measures (EQ-5D_index, p = 0.004; EQ-5D_VAS, p = 0.017; QLMI-Q, p ≤ 0.001; and IIEF-5, p = 0.001). CONCLUSION The neuromuscular strength training programme was more effective than the classic strength training programme in terms of increasing the HRQoL and improving erectile dysfunction in patients following acute coronary syndrome, with differences still remaining between these groups at the 6-month follow-up.
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Affiliation(s)
- Noemí Valtueña-Gimeno
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
| | - Francisco José Ferrer-Sargues
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
| | - Oscar Fabregat-Andrés
- Department of Medicine, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
- Department of Cardiology, Hospital IMED, Av. de la ilustración, 1, 46100, Burjassot, Valencia, Spain
| | - Isabel Martínez-Hurtado
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
| | - F J Martínez-Olmos
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
| | - Marta Lluesma-Vidal
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain.
| | - María Dolores Arguisuelas
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Calle Santiago Ramón y Cajal, 20, 46115, Alfara del Patriarca, Valencia, Spain
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Khong A, Liu N, Giancaterino S, Junker M, Labiak R, Cortez-Toledo E, Fausto AGB, Andrade H, Chen C, López JE. Medical Disruptions During Center-Based Cardiac Rehabilitation: A Necessary Appraisal for the Development of Emerging Remote and Virtual Care Models. J Cardiopulm Rehabil Prev 2023; 43:329-337. [PMID: 36811521 DOI: 10.1097/hcr.0000000000000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
PURPOSE The purpose of this study is to show that with remote and virtual cardiac rehabilitation (CR) care models rapidly emerging, CR core components must be maintained to prioritize safety and effectiveness. Currently, there is a paucity of data on medical disruptions in phase 2 center-based CR (cCR). This study aimed to characterize the frequency and types of unplanned medical disruptions. METHODS We reviewed 5038 consecutive sessions from 251 patients enrolled in cCR program from October 2018 to September 2021. Quantification of events was normalized to sessions to control for multiple disruptions that occurred to a single patient. A multivariate logistical regression model was used to predict comorbid risk factors for disruptions. RESULTS Fifty percent of patients experienced one or more disruptions during cCR. Glycemic events (71%) and blood pressure (12%) abnormalities accounted for most of these while symptomatic arrhythmias (8%) and chest pain (7%) were less frequent. Sixty-six percent of events occurred within the first 12 wk. The regression model showed that a diagnosis of diabetes mellitus was the strongest predictor for disruptions (OR = 2.66: 95% CI, 1.57-4.52; P < .0001). CONCLUSIONS Medical disruptions were frequent during cCR, with glycemic events being most common and occurring early. A diagnosis of diabetes mellitus was a strong independent risk factor for events. This appraisal suggests that patients living with diabetes mellitus, particularly those on insulin, need to be the highest priority for monitoring and planning and suggests that a hybrid care model may be beneficial in this population.
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Affiliation(s)
- Anthony Khong
- Department of Internal Medicine (Drs Khong and Liu) and Division of Cardiovascular Medicine (Drs Giancaterino, Chen, and López, Mss Junker, Labiak, Cortez-Toledo, and Fausto, and Mr Andrade), UC Davis Health, Davis, California
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Mihalko SL, Katula JA, Brubaker PH. Not a One-Way Street: UNDERSTANDING THE MANY ROADS THAT LEAD TO EXERCISE ADHERENCE. J Cardiopulm Rehabil Prev 2023; 43:153-155. [PMID: 37115953 DOI: 10.1097/hcr.0000000000000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Shannon L Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
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Raisi A, Zerbini V, Myers J, Piva T, Campo G, Mazzoni G, Grazzi G, Mandini S. A Novel Motivational Approach in the Management of Older Patients With Cardiovascular Disease. J Cardiopulm Rehabil Prev 2023:01273116-990000000-00084. [PMID: 37014940 DOI: 10.1097/hcr.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sports, University of Ferrara, Ferrara, Italy (Messrs Raisi and Piva, Ms Zerbini, and Drs Mazzoni, Grazzi, and Mandini); Division of Cardiology, VA, Palo Alto, California (Dr Myers); Stanford University School of Medicine, Stanford, California (Dr Myers); Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, Illinois (Drs Myers and Grazzi); Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy (Dr Campo); and Public Health Department, AUSL Ferrara, Ferrara, Italy (Drs Mazzoni and Grazzi)
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11
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Yang Z, Sun L, Sun Y, Dong Y, Wang A. A Conceptual Model of Home-Based Cardiac Rehabilitation Exercise Adherence in Patients with Chronic Heart Failure: A Constructivist Grounded Theory Study. Patient Prefer Adherence 2023; 17:851-860. [PMID: 36999162 PMCID: PMC10044075 DOI: 10.2147/ppa.s404287] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
Purpose This study aimed to explore a conceptual model of home-based cardiac rehabilitation exercise adherence and reveal its internal behavioral logic. Patients and Methods A constructivist grounded theory design was adopted to explore the conceptual model of home-based cardiac rehabilitation exercise adherence. Semi-structured interviews were completed to collect qualitative data for constructing the conceptual model. The theoretical saturation and validation strategies were adopted to demonstrate the adequacy of qualitative data. A three-level coding procedure with constant comparisons was completed to analyze this qualitative data. Results A total of 21 patients with chronic heart failure were recruited in this study. As a result of this study, 32 initial codes, 12 category codes, and four core categories were extracted, namely, seeking supports, rehabilitation exercise, exercise monitoring and information feedback. According to the internal behavioral logic, the conceptual model of home cardiac rehabilitation exercise adherence was finally formed. In this closed-chain model, seeking supports is the initial adherence behavior, and rehabilitation exercise is the core adherence behavior, and exercise monitoring is the key adherence behavior, and information feedback is the driving adherence behavior. Conclusion The conceptual model of home-based cardiac rehabilitation exercise adherence in patients with chronic heart failure was developed, revealing its internal behavioral logic and providing theoretical references for developing relevant clinical research tools with comprehensive coverage and identifying weak links.
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Affiliation(s)
- Zhen Yang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Longfeng Sun
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yuanhui Sun
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yu Dong
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
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What's the Alternative?: CONSIDERING THE PATIENT PERSPECTIVE OF ALTERNATIVE CARDIAC REHABILITATION PROGRAMMING. J Cardiopulm Rehabil Prev 2023; 43:81-82. [PMID: 36826386 DOI: 10.1097/hcr.0000000000000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Tilgner N, Nehls D, Lichtmess C, Kober A, Küsel C, Radloff L, Gabrys L. Adherence to exercise and fitness following exercise-based outpatient cardiac rehabilitation: a cross-sectional survey for Germany. BMC Sports Sci Med Rehabil 2022; 14:191. [DOI: 10.1186/s13102-022-00585-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Exercise-based cardiac rehabilitation is safe and effective, evidence-based and implemented in national and international cardiac rehabilitation guidelines. Recent data show a decrease in cardiovascular mortality, reduced hospital admissions and an overall improvement in quality of life. To maintain positive effects and to prevent further cardiovascular events a major goal of cardiac rehabilitation is to induce a long-term health behaviour change and the integration of regular physical activity and exercise training in everyday life. The aim of this study is to evaluate the adherence of cardiac patients to exercise-based programs following rehabilitation phase III.
Methods
A nationwide online cross-sectional survey was conducted. All outpatient aftercare providers who offer sports rehabilitation programs (heart groups) for cardiac patients in Germany were contacted. The questionnaire comprised 15 questions in five subcategories (general information regarding the outpatient aftercare provider, structure of rehabilitation sport programs, membership structure, content of heart groups, adherence to exercise-based programs).
Results
560 of 2447 outpatient aftercare providers participated in the survey (response rate: 23%). On average, rehabilitation sport facilities hosted 2 (IQR 2) heart groups per week, and 23 patients (IQR 30) (61% males; 31% females) per facility completed rehabilitation sport prescription in 2018. Almost all providers offer follow-up programs on a self-payer basis after rehabilitation sport prescription ends. Adherence to follow-up programs was at 54% (IQR 65; 55% males and 50% females). With 60% (IQR 71), patients with a statutory health insurance (mainly pensioners) adhere slightly more often to a follow-up program compared to privately insured persons (mainly population with a high income or civil servants) with 50% and significantly more often compared to persons who were insured by the German pension fund (covering working population) with only 9% (IQR 89) adherence.
Conclusion
Almost all outpatient aftercare providers offer follow-up programs for cardiac rehabilitation patients but only half of them actually participate. Younger people (working population) do not adhere sufficiently to sport and exercise programs following rehabilitation phase III. This seems critical to address in terms of achieving long-term rehabilitation goals.
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Supervia M. Cardiac Rehabilitation Completion Study: Barriers and Potential Solutions. J Cardiopulm Rehabil Prev 2022; 42:375-377. [PMID: 36044761 PMCID: PMC9794120 DOI: 10.1097/hcr.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Marta Supervia
- Gregorio Marañón Health Research Institute, Gregorio Marañón General University Hospital, Madrid, Spain Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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