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Wang Z, Elkoustaf R, Batiste C, Lahti D, Yao JF, Funahashi T. Home based cardiac rehabilitation: A retrospective cohort analysis on all-cause mortality and hospital readmission rates across sexes and races. Am J Prev Cardiol 2024; 19:100708. [PMID: 39157645 PMCID: PMC11328006 DOI: 10.1016/j.ajpc.2024.100708] [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: 12/14/2023] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 08/20/2024] Open
Abstract
Objective Studies have shown that both home-based cardiac rehabilitation (HBCR) and center-based cardiac rehabilitation (CBCR) exhibit comparable efficacy in reducing mortality during short-term follow-up periods of up to 12 months. However, research on sex- and race-specific outcomes associated with HBCR is limited. This study examines all-cause mortality and hospital readmission among patients referred to HBCR, with stratification by sex and race. Methods This Kaiser Permanente Southern California (KPSC) retrospective cohort study followed 6,868 patients from HBCR referral until death, disenrollment, or December 31, 2021. There were 3,835 HBCR graduates, 722 non-graduates, and 2,311 non-enrolled patients. Cox models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) comparing 1) HBCR graduates vs. non-enrolled, and 2) HBCR graduates vs. non-graduates, stratified by sex and race. Differential outcomes among strata were analyzed using Kaplan-Meier curves. Results Among the 6,868 patients referred to HBCR, 4693 (68.3 %) were male, 2,175 (31.7 %) female, 870 (12.7 %) Asian/Pacific Islander, 731 (10.6 %) African American, 1,612 (23.6 %) Hispanic/Latino, and 3,646 non-Hispanic White (53.1 %). Over a mean follow-up period of 2.28 years, HBCR graduates, compared to patients who did not enroll in HBCR, had overall significantly lower risks of all-cause mortality and hospitalization. These results remained significant with stratification by sex and race. Compared to HBCR non-graduates, HBCR graduates overall had significantly lower risks of all-cause mortality and hospitalization. In the same comparison, mortality risk was significantly reduced for male and White patients; risk of hospital readmission was significantly reduced in both sexes, African American, and White patients. Among HBCR graduates, no significant differences in all-cause mortality or hospital readmission were observed across sexes and races. Conclusion HBCR participation is associated with reduction of all-cause mortality and hospital readmission rates across sexes and races. Notably, we observed benefits at varying levels of engagement, which suggests that even partial completion of HBCR is associated with risk reduction. Among HBCR graduates, we found similar outcomes across sexes and races, which suggests that the program can be effective among diverse patient groups.
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Affiliation(s)
- Zhengran Wang
- Susan Samueli Integrative Health Institute, University of California, Irvine, Irvine, CA, USA
- Division of Cardiology, University of California, Irvine School of Medicine, Irvine CA, USA
| | | | | | - Debora Lahti
- Kaiser Permanente Center for Health Innovation, Tustin, CA, USA
| | - Janis F. Yao
- Kaiser Permanente Department of Research and Evaluation, Pasadena, CA, USA
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Jansson AK, Schumacher TL, Kocanda L, Whatnall M, Fenwick M, Betts D, Bauman A, Kerr J, Duncan MJ, Collins CE, Boyle A, Inder KJ, Plotnikoff RC. A Systematic Review of the Completion of Cardiac Rehabilitation Programs for Adults Aged 18-50 Years. J Cardiopulm Rehabil Prev 2024; 44:E30-E51. [PMID: 39185913 DOI: 10.1097/hcr.0000000000000881] [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: 08/27/2024]
Abstract
OBJECTIVE To perform a systematic review of completion rates of cardiac rehabilitation (CR) in adults aged 18 to 50 yr and describe how core components were reported, measured, and tailored to those under 50 yr. REVIEW METHODS Database search of MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and the Cochrane Library based on keywords, including articles from January 1, 1990. The last search was performed on April 21, 2023. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol, eligible articles contained adults (aged between 18 and 50 yr) who had participated in a CR program. SUMMARY Out of the articles screened (n = 24,517), 33 reports across 31 independent studies were considered eligible (n = 1958 patients aged ≤50 yr). Cardiac rehabilitation completion rates ranged from 64% to 100%; however, only 5 studies presented a completion rate definition. The length of the program ranged from 7 d to 20 wk, with most (65%) ranging between 6 and 12 wk. While the studies included in this systematic review indicated relatively high rates of completing CR, these are likely to overrepresent the true completion rates as few definitions were provided that could be compared to completion rates used in clinical practice. This systematic review also found that all interventions prescribed exercise (eg, aerobic alone or combined with resistance training or yoga) but had very limited inclusion or description of other integral components of CR (eg, initial assessment and smoking cessation) or how they were assessed and individualized to meet the needs of younger attendees.
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Affiliation(s)
- Anna K Jansson
- Author Affiliations: Centre for Active Living and Learning, School of Education, The University of Newcastle, Newcastle, New South Wales, Australia (Drs Jansson and Plotnikoff); Active Living Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia (Dr Jansson, Mr Fenwick, and Drs Duncan and Plotnikoff); Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia (Drs Schumacher and Kocanda); School of Health Science, College of Health and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia (Drs Whatnall and Collins); Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia (Drs Kocanda, Whatnall, and Collins); School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia (Mr Fenwick and Drs Duncan and Boyle); Cancer Council NSW, Sydney, New South Wales, Australia (Mrs Betts); School of Public Health, University of Sydney, Sydney, New South Wales, Australia (Dr Bauman); Hunter New England Health, Newcastle, New South Wales, Australia (Ms Kerr and Dr Inder); and School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia (Dr Inder)
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Kim C, Song JH, Kim SH. The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era. Ann Rehabil Med 2024; 48:249-258. [PMID: 39074836 PMCID: PMC11372283 DOI: 10.5535/arm.240021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVE To prospectively compare the efficacy of conventional center-based cardiac rehabilitation (CBCR) and home-based cardiac rehabilitation (HBCR) during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Ninety Patients were divided into HBCR and CBCR groups based on cardiovascular risk stratification and individual preference. The CBCR group performed supervised in-hospital exercise training 2-3 times/week and subsequent self-exercise at home. The HBCR group performed self-exercise at home after one or two sessions of exercise education. The cardiopulmonary exercise test results at baseline and those at the 3-, 6-, and 12-month follow-ups were analyzed as primary outcome. RESULTS The peak oxygen consumption (peak VO2, mL/kg/min) in the CBCR group was 20.1 and 24.0 at baseline and 12 months, respectively, showing significant improvement (p=0.006). In the HBCR group, it only increased from 24.4 to 25.5, showing suboptimal improvement. A significant increase in the Korean activity scale/index was confirmed only in the CBCR group (p=0.04). The cardiovascular outcome did not differ between the two groups, nor did the dropout rate or demographic factors. CONCLUSION During the COVID-19 pandemic, only CBCR was associated with a significant improvement in peak VO2 and physical activity levels, a finding that differs from those of other studies and seems to be affected by COVID-19. Therefore, in situations where the importance of HBCR is emphasized, it is essential to introduce measures to monitor and enhance exercise adherence among participants.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jun Hyeong Song
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Seung Hyoun Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Jug B, Sedlar Kobe N, Stojinic D, Lainscak M, Farkas J. Cardiac rehabilitation patient perspectives during COVID-19 pandemic: quantitative and qualitative study. Front Cardiovasc Med 2024; 11:1373684. [PMID: 39139755 PMCID: PMC11319166 DOI: 10.3389/fcvm.2024.1373684] [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: 01/20/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024] Open
Abstract
Background This study aimed to quantitatively assess stress, anxiety and obsessive thinking related to coronavirus disease-19 (COVID-19) and qualitatively appraise perceptions in patients after acute myocardial infarction (AMI) undergoing cardiac rehabilitation (CR) during the COVID-19 pandemic. Methods We used mixed-methods design in patients referred for CR in 2 centres which delivered uninterrupted service during COVID-19 pandemic. Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS), COVID-19 Stress Scale (CSS), Hospital Anxiety and Depression Scale (HADS), and in-person interviews (combination of a priori questions and probing) were used to evaluate patient experience and perceptions with COVID-19 and the healthcare services during pandemic. Results In total, 109 patients (mean age 59 ± 10, 20% women) were included in quantitative part and in 30 of them we conducted the in-person interviews. About a quarter of patients met HADS threshold for anxiety and depression while CAS and OCS results demonstrated extremely low possibility of coronavirus related dysfunctional thinking (3%) and anxiety (2%). The CSS indicated the most prevalent concerns were related to COVID-19 vaccines safety (60%) and fear of getting infected (60%). During interviews, patients perceived the CR as well as health care providers as safe, trustworthy and with enough support to avoid or manage COVID-19 related health risks. Conclusions Overall, patients reported AMI affected their lives more than the COVID-19 pandemic. The COVID-19 related stress and anxiety were relatively low and mostly related to general views of infectious disease. CR was perceived safe and trustworthy in terms of primary disease and COVID-19. Lay summary This mixed-method study included 109 patients with acute myocardial infarction who underwent cardiac rehabilitation during the COVID-19 and focused on their experience and perceptions with COVID-19 and the healthcare services during pandemic.-Patients reported acute myocardial infarction affected their lives more than the COVID-19 pandemic.-The COVID-19 related concerns were mostly related to general views of infectious disease (vaccine safety, fear of getting infected) whilst cardiac rehabilitation was perceived safe and trustworthy environment during COVID-19.
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Affiliation(s)
- Borut Jug
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | | | - Mitja Lainscak
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- General Hospital Murska Sobota, Murska Sobota, Slovenia
| | - Jerneja Farkas
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- General Hospital Murska Sobota, Murska Sobota, Slovenia
- National Institute of Public Health, Ljubljana, Slovenia
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Ngo-Hamilton A, Agakishiev D, Maharaj V. Cardiac rehabilitation for heart failure: progress and gaps in evidence and policy. Curr Opin Cardiol 2024; 39:196-201. [PMID: 38391275 DOI: 10.1097/hco.0000000000001129] [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: 02/24/2024]
Abstract
PURPOSE OF REVIEW This review synthesizes recent research on the efficacy, optimal design, and delivery methods of cardiac rehabilitation tailored to heart failure patients. Despite established benefits, cardiac rehabilitation referral and access disparities persist, necessitating elucidation of limitations and solutions. RECENT FINDINGS Exercise-based cardiac rehabilitation improves long-term mortality and hospitalization rates but not short-term mortality. cardiac rehabilitation further enhances quality of life and medical therapy adherence. However, cardiac rehabilitation relies on in-person delivery, presenting access barriers exacerbated during COVID-19. Significant geographic disparities exist, with analyses indicating current capacity only serves 45% of eligible US adults even if fully utilized. Referral rates also lag, disproportionately affecting women and minority groups. Research increasingly focuses on home-based and digital therapeutics modalities to expand reach, with evidence demonstrating comparable improvements across settings. Protocols and research center on heart failure with reduced ejection fraction (HFrEF), despite growing heart failure with preserved ejection fraction (HFpEF) prevalence. SUMMARY Increasing referrals through standardized procedures and addressing multifactorial geographic, economic, and capacity limitations are imperative to ensure equitable cardiac rehabilitation access. Broadening HFpEF rehabilitation research and care standards also constitutes a critical practice gap requiring alignment with projected epidemiologic shifts. Advancing patient-centered, evidence-based solutions can promote rehabilitation as essential secondary prevention for wider cardiac populations. VIDEO ABSTRACT http://links.lww.com/HCO/A97.
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Affiliation(s)
- Alfred Ngo-Hamilton
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dzhalal Agakishiev
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
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Hollings M, Gordon N, Redfern J, Thomas L, Singleton A, Tu Q, Zecchin R. Characteristics and Outcomes of Cardiac Rehabilitation Patients With and Without Cancer: Insights From Western Sydney. Heart Lung Circ 2024; 33:730-737. [PMID: 38233306 DOI: 10.1016/j.hlc.2023.11.017] [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: 07/23/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 01/19/2024]
Abstract
AIM Increased cardiovascular events are common in cancer survivors and contribute to an emerging cardio-oncology patient group requiring secondary prevention strategies including cardiac rehabilitation (CR). This study aimed to compare characteristics and outcomes for patients participating in CR with and without an existing cancer diagnosis. METHOD Observational cohort study including consecutive patients enrolled in a single-centre outpatient CR program in Western Sydney between 2018-2022. Clinical history, demographics and CR outcome data were collected as part of standard care at program enrolment and completion. Patients with and without a cancer diagnosis were compared at enrolment and outcomes were analysed in both groups. RESULTS A total of 1,792 patients enrolled in CR, 191 (11%) had a documented history of cancer; prostate (18%), skin (12%), colon (9%) and breast (8%) malignancies were most prevalent. The most common treatments were surgical resection (80%) and chemotherapy or radiotherapy (37%). Cardio-oncology patients were older (68.8±10.6 vs 59.8±13.7yrs, p<0.001), more likely female (33% vs 21%, p<0.001), born in Australia (46% vs 35%, p=0.004), non-partnered (34% vs 25%, p=0.002) and had a prior history of hypertension (65% vs 56%, p=0.010) or stroke (8% vs 5%, p=0.045). After adjusting for age and sex, the overall cohort improved their mean peak exercise capacity and waist circumference after CR, however there were no differences between groups. There were also no between-group differences for adherence and completion of CR program or any other cardiovascular risk factors. Sub-analyses revealed a clinically meaningful improvement in waist circumference for cancer patients with a history of radiation therapy and a blunted peak exercise capacity adaptation for those with a history of chemotherapy treatment. CONCLUSIONS Despite differences in demographic and clinical characteristics of CR patients with and without cancer, all patients showed significant and clinically relevant improvements in peak exercise capacity and waist circumference after CR. Results also highlighted potential associations between specific cancer treatments and changes in fitness outcomes, which warrants further evaluation.
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Affiliation(s)
- Matthew Hollings
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Nicole Gordon
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; South West Clinical School, School of Clinical Medicine, University of NSW, Sydney, NSW, Australia
| | - Anna Singleton
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Qiang Tu
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Robert Zecchin
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
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Ferrel-Yui D, Candelaria D, Pettersen TR, Gallagher R, Shi W. Uptake and implementation of cardiac telerehabilitation: A systematic review of provider and system barriers and enablers. Int J Med Inform 2024; 184:105346. [PMID: 38281451 DOI: 10.1016/j.ijmedinf.2024.105346] [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: 08/29/2023] [Accepted: 01/20/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cardiac telerehabilitation has demonstrated effectiveness for patient health outcomes, but uptake and implementation into practice have been limited and variable. While patient-level influences on uptake have been identified, little is known about provider- and system-level factors. AIMS To identify provider and system barriers and enablers to uptake and implementation of cardiac telerehabilitation. METHODS A systematic review was conducted, including a search of six databases (MEDLINE, Embase, CINAHL, Scopus, Web of Science, and PsycINFO) from 2000 to March 2023. Two reviewers independently screened eligible articles. Study quality was evaluated according to study design by the Critical Appraisal Skills Programme (CASP) checklist for qualitative data, the Appraisal Tool for Cross-sectional Studies (AXIS), and the Mixed Methods Appraisal Tool (MMAT) for mixed methods. Data were analysed using narrative synthesis. RESULTS Twenty eligible studies (total 1674 participants) were included. Perceived provider-level barriers included that cardiac telerehabilitation is resource intensive, inferior to centre-based delivery, and lack of staff preparation. Whereas provider-level enablers were having access to resources, adequate staff preparation, positive staff beliefs regarding cardiac telerehabilitation and positive team dynamics. System-level barriers related to unaligned policy, healthcare system and insurance structures, technology issues, lack of plans for implementation, and inadequate resources. System-level enablers included cost-effectiveness, technology availability, reliability, and adaptability, and adequate program development, implementation planning and leadership support. CONCLUSIONS Barriers and enablers at both provider and system levels must be recognised and addressed at the local context to ensure better uptake of cardiac telerehabilitation programs.
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Affiliation(s)
- Daniel Ferrel-Yui
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia
| | - Dion Candelaria
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia.
| | - Trond Røed Pettersen
- Haukeland University Hospital, Department of Heart Disease, Box 1400, 5021, Bergen, Norway
| | - Robyn Gallagher
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia
| | - Wendan Shi
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia; St George Hospital, Centre for Research in Nursing and Health, Gray Street, Kogarah, New South Wales 2217, Australia
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Zeller A, Gutenberg J, Niebauer J, Crutzen R, Kulnik ST. Patients' experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study. Front Sports Act Living 2024; 6:1371652. [PMID: 38567184 PMCID: PMC10986307 DOI: 10.3389/fspor.2024.1371652] [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: 01/16/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Despite the well-known benefits of exercise-based cardiac rehabilitation for the secondary prevention of cardiovascular disease, participation in cardiac rehabilitation programmes and adherence to secondary prevention recommendations remain limited. Digital technologies have the potential to address low participation and adherence but attempts at implementing digital health interventions in real-life clinical practice frequently encounter various barriers. Studies about patients' experiences and perspectives regarding the use of digital technology can assist developers, researchers and clinicians in addressing or pre-empting patient-related barriers. This study was therefore conducted to investigate the experiences and perspectives of cardiac rehabilitation patients in Austria with regard to using digital technology for physical activity and exercise. Methods Twenty-five current and former cardiac rehabilitation patients (18 men and 7 women, age range 39 to 83) with various cardiac conditions were recruited from a clinical site in Salzburg, Austria. Semi-structured qualitative interviews were audio-recorded and transcribed verbatim. The analysis followed a descriptive phenomenological approach, applying the framework analysis method. Results The sample was diverse, including interviewees who readily used digital devices to support their physical activity, exercise and health monitoring, and interviewees who did not. Simplicity, convenience and accessibility were highlighted as important facilitators for the use of digital technology, while annoyance with digital devices, concerns about becoming dependent on them, or simply a preference to not use digital technology were commonly stated reasons for non-use. Interviewees' views on data protection, data sharing and artificial intelligence revealed wide variations in individuals' prior knowledge and experience about these topics, and a need for greater accessibility and transparency of data protection regulation and data sharing arrangements. Discussion These findings support the importance that is attributed to user-centred design methodologies in the conceptualisation and design of digital health interventions, and the imperative to develop solutions that are simple, accessible and that can be personalised according to the preferences and capabilities of the individual patient. Regarding data protection, data sharing and artificial intelligence, the findings indicate opportunity for information and education, as well as the need to offer patients transparency and accountability in order to build trust in digital technology and digital health interventions.
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Affiliation(s)
- Anna Zeller
- Faculty of Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Johanna Gutenberg
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
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Hong C, Yan Q, Qi H, Zhang Y, Yu L, Dong L, Wang J. Acceptability, Preferred Medium, and Components of Nurse-Led Cardiac Telerehabilitation: A Cross-Sectional Study. Clin Nurs Res 2024; 33:146-156. [PMID: 38291821 DOI: 10.1177/10547738241228634] [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] [Indexed: 02/01/2024]
Abstract
Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t-test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program.
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Affiliation(s)
- Chaochao Hong
- School of Nursing, Nanchang University, Jiangxi Province, China
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Qiong Yan
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Hongmei Qi
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Yaoyao Zhang
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Ling Yu
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Lijie Dong
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Jing Wang
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
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Purcell C, Purvis A, Cleland JGF, Cowie A, Dalal HM, Ibbotson T, Murphy C, Taylor RS. Home-based cardiac rehabilitation for people with heart failure and their caregivers: a mixed-methods analysis of the roll out an evidence-based programme in Scotland (SCOT:REACH-HF study). Eur J Cardiovasc Nurs 2023; 22:804-813. [PMID: 36617216 DOI: 10.1093/eurjcn/zvad004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/29/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
AIMS Alternative models of cardiac rehabilitation (CR) are required to improve CR access and uptake. Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is a comprehensive home-based rehabilitation and self-management programme, facilitated by trained health professionals, for people with heart failure (HF) and their caregivers. REACH-HF was shown to be clinically effective and cost-effective in a multi-centre randomized trial. The SCOT:REACH-HF study assessed implementation of REACH-HF in routine clinical practice in NHS Scotland. METHODS AND RESULTS A mixed-method implementation study was conducted across six regional Health Boards. Of 136 people with HF and 56 caregivers recruited, 101 people with HF and 26 caregivers provided 4-month follow-up data, after participating in the 12-week programme. Compared with baseline, REACH-HF participation resulted in substantial gains in the primary outcome of health-related quality of life, as assessed by the Minnesota Living with Heart Failure Questionnaire (mean difference: -9.8, 95% CI: -13.2 to -6.4, P < 0.001). Improvements were also seen in secondary outcomes (PROM-CR+; EQ-5D-5L; Self-Care of Heart Failure Index (SCHFI) domains of maintenance and symptom perception; Caregiver Contribution to Self-Care domains of symptom perception and management). Twenty qualitative interviews were conducted with 11 REACH-HF facilitators, five supporting clinicians, and four national stakeholders. Interviewees were largely positive about REACH-HF, considering it to have 'filled a gap' where centre-based CR was not an option. Key issues to support future roll-out were also identified. CONCLUSION Our findings support wider roll-out of REACH-HF as an alternative to centre-based models, to improve CR access and uptake for people with HF.
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Affiliation(s)
- Carrie Purcell
- Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, 10 Drumsheugh Gardens, Edinburgh EH3 7QJ, UK
| | - Anthony Purvis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley St, Glasgow G3 7HR, UK
| | - John G F Cleland
- Robertson Centre for Biostatistics, University of Glasgow, Level 11, Boyd Orr Building, University Avenue, Glasgow G12 8QQ, UK
| | - Aynsley Cowie
- NHS Ayrshire and Arran, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK
| | - Hasnain M Dalal
- Primary Care Research Group, University of Exeter Medical School, St Luke's Campus, Exeter EX1 2LU, UK
| | - Tracy Ibbotson
- General Practice & Primary Care, University of Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK
| | - Clare Murphy
- NHS Forth Valley, Forth Valley Royal Hospital, Stirling Road, Larbert FK5 4WR, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley St, Glasgow G3 7HR, UK
- Robertson Centre for Biostatistics, University of Glasgow, Level 11, Boyd Orr Building, University Avenue, Glasgow G12 8QQ, UK
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11
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Akhter N, Dent S. Cardio-Oncology Rehabilitation Programs-The Next Phase in Improving Care for Cancer Survivors. JAMA Cardiol 2023; 8:1128-1130. [PMID: 37819675 DOI: 10.1001/jamacardio.2023.3568] [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: 10/13/2023]
Affiliation(s)
- Nausheen Akhter
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Susan Dent
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, North Carolina
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12
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Bloor L, Stelmokas J, Chrouser K, Tsao P, Gupta J, Duvernoy C. Prioritizing the integration of biological and psychological healthcare to improve both patient outcomes and clinician well-being. Gen Hosp Psychiatry 2023; 85:245-246. [PMID: 37658023 DOI: 10.1016/j.genhosppsych.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/30/2023] [Accepted: 08/02/2023] [Indexed: 09/03/2023]
Affiliation(s)
- Lindsey Bloor
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, United States of America.
| | - Julija Stelmokas
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, United States of America; VA NY Harbor Healthcare System- Brooklyn Campus, New York, United States of America
| | - Kristin Chrouser
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; University of Michigan, Department of Urology, Ann Arbor, MI, United States of America
| | - Phoebe Tsao
- VA Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America; Institute of Health Policy and Innovation, University of Michigan Medical School, Ann Arbor, MI, United States of America
| | - Jessica Gupta
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; University of Michigan Medical School, Department of Cardiology, United States of America
| | - Claire Duvernoy
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; University of Michigan Medical School, Department of Cardiology, United States of America
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13
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Thompson S, Stickland MK, Wilund K, Gyenes GT, Bohm C. Exercise Rehabilitation for People With End-Stage Kidney Disease: Who Will Fill the Gaps? Can J Cardiol 2023; 39:S335-S345. [PMID: 37597748 DOI: 10.1016/j.cjca.2023.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/21/2023] Open
Abstract
Exercise rehabilitation is a well established therapy for reducing morbidity and mortality and improving quality of life and function across chronic conditions. People with dialysis-dependent kidney failure have a high burden of comorbidity and symptoms, commonly characterised as fatigue, dyspnoea, and the inability to complete daily activities. Despite more than 30 years of exercise research in people with kidney disease and its established benefit in other chronic diseases, exercise programs are rare in kidney care and are not incorporated into routine management at any stage. In this review, we describe the mechanisms contributing to exercise intolerance in those with end-stage kidney disease and outline the role of exercise rehabilitation in addressing the major challenges to kidney care: cardiovascular disease, symptom burden, and physical frailty. We also draw on existing models of exercise rehabilitation from other chronic conditions to inform the way forward and challenge the status quo of exercise rehabilitation in both practice and research.
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Affiliation(s)
- Stephanie Thompson
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | | | - Kenneth Wilund
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, USA
| | - Gabor T Gyenes
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Clara Bohm
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
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14
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Redfern J, Shang C, Hsu MP, Doyle K, Nutbeam D, Audehm R, Inglis SC, Hamilton-Craig C, Raffoul N, Shaw T, Figtree GA, Jennings G. Cardiovascular Disease Implementation and Policy Priorities for Australia: Recommendations From an Australian Stakeholder Roundtable. Heart Lung Circ 2023; 32:1141-1147. [PMID: 37758637 DOI: 10.1016/j.hlc.2023.07.009] [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: 07/03/2023] [Accepted: 07/15/2023] [Indexed: 09/29/2023]
Abstract
The Australian Cardiovascular Alliance (ACvA), the Cardiac Society of Australia and New Zealand (CSANZ) and the National Heart Foundation of Australia (NHFA) recently joined forces to bring the cardiovascular and stroke community together to convene and document a national discussion and propose a national CVD Implementation and Policy agenda and action plan. This includes prevention and screening, acute care and secondary prevention.
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Affiliation(s)
- Julie Redfern
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AUSTRALIA; Australian Cardiovascular Alliance, Australia.
| | | | | | - Kerry Doyle
- Australian Cardiovascular Alliance, Australia
| | - Don Nutbeam
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AUSTRALIA; Sydney Health Partners, Charles Perkins Centre, Sydney, NSW, Australia
| | - Ralph Audehm
- National Heart Foundation of Australia, Australia; Department of General Practice and Primary Healthcare, University of Medicine, Melbourne, Vic, Australia
| | - Sally C Inglis
- Cardiac Society of Australia and New Zealand, Sydney, Australia; University of Technology Sydney, Sydney, NSW, Australia
| | - Christian Hamilton-Craig
- Cardiac Society of Australia and New Zealand, Sydney, Australia; Faculty of Medicine, University of Queensland and Centre for Advanced Imaging, Brisbane, Qld, Australia
| | | | - Timothy Shaw
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AUSTRALIA
| | - Gemma A Figtree
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AUSTRALIA; Australian Cardiovascular Alliance, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Garry Jennings
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AUSTRALIA; Australian Cardiovascular Alliance, Australia; Sydney Health Partners, Charles Perkins Centre, Sydney, NSW, Australia; National Heart Foundation of Australia, Australia
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15
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Ramachandran HJ, Seah ACW, Teo JYC, Yeo TJ, Wang W. East meets West: making the case for traditional Chinese exercises in the management of heart disease. Eur J Cardiovasc Nurs 2023; 22:e47-e48. [PMID: 36595034 DOI: 10.1093/eurjcn/zvad006] [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] [Received: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Jun Yi Claire Teo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
| | - Tee Joo Yeo
- Cardiac Rehabilitation, Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, 119074 Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, 117597Singapore
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16
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Verdicchio C, Freene N, Hollings M, Maiorana A, Briffa T, Gallagher R, Hendriks JM, Abell B, Brown A, Colquhoun D, Howden E, Hansen D, Reading S, Redfern J. A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. A CSANZ Position Statement. Heart Lung Circ 2023; 32:1035-1048. [PMID: 37516652 DOI: 10.1016/j.hlc.2023.06.854] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/31/2023]
Abstract
Patients with cardiovascular disease benefit from cardiac rehabilitation, which includes structured exercise and physical activity as core components. This position statement provides pragmatic, evidence-based guidance for the assessment and prescription of exercise and physical activity for cardiac rehabilitation clinicians, recognising the latest international guidelines, scientific evidence and the increasing use of technology and virtual delivery methods. The patient-centred assessment and prescription of aerobic exercise, resistance exercise and physical activity have been addressed, including progression and safety considerations.
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Affiliation(s)
- Christian Verdicchio
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Heart Rhythm Disorders, University of Adelaide, SAHMRI and Royal Adelaide Hospital, Adelaide, SA, Australia.
| | - Nicole Freene
- Physiotherapy, Faculty of Health, University of Canberra, Canberra, ACT, Australia; Health Research Institute, University of Canberra, Canberra, ACT, Australia
| | - Matthew Hollings
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Andrew Maiorana
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, Australia; Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Tom Briffa
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jeroen M Hendriks
- Centre for Heart Rhythm Disorders, University of Adelaide, SAHMRI and Royal Adelaide Hospital, Adelaide, SA, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Bridget Abell
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia
| | - Alex Brown
- Telethon Kids Institute, Australian National University, Canberra, ACT, Australia
| | - David Colquhoun
- Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia; Faculty of Medicine, Wesley Medical Centre, Brisbane, Qld, Australia
| | - Erin Howden
- Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Melbourne, Vic, Australia
| | - Dominique Hansen
- UHasselt, REVAL/BIOMED (Rehabilitation Research Centre), Hasselt University, Hasselt, Belgium
| | - Stacey Reading
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Julie Redfern
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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17
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Grace SL, Taylor RS, Gaalema DE, Redfern J, Kotseva K, Ghisi G. Cardiac Rehabilitation: A Global Perspective on Where We Have Come and Where We Must Go. JACC. ADVANCES 2023; 2:100412. [PMID: 38938991 PMCID: PMC11198422 DOI: 10.1016/j.jacadv.2023.100412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Sherry L. Grace
- Faculty of Health, York University, Toronto, Ontario, Canada
- KITE Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Rod S. Taylor
- Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, School of Health and Well Being, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Diann E. Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, USA
| | - Julie Redfern
- Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, Australia
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Kornelia Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland-Galway, Galway, Ireland
| | - Gabriela Ghisi
- Faculty of Health, York University, Toronto, Ontario, Canada
- KITE Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
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18
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Taylor RS, Dalal HM, Zwisler AD. Cardiac rehabilitation for heart failure: 'Cinderella' or evidence-based pillar of care? Eur Heart J 2023; 44:1511-1518. [PMID: 36905176 PMCID: PMC10149531 DOI: 10.1093/eurheartj/ehad118] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/19/2022] [Accepted: 02/17/2023] [Indexed: 03/12/2023] Open
Abstract
Cardiac rehabilitation remains the 'Cinderella' of treatments for heart failure. This state-of-the-art review provides a contemporary update on the evidence base, clinical guidance, and status of cardiac rehabilitation delivery for patients with heart failure. Given that cardiac rehabilitation participation results in important improvements in patient outcomes, including health-related quality of life, this review argues that an exercise-based rehabilitation is a key pillar of heart failure management alongside drug and medical device provision. To drive future improvements in access and uptake, health services should offer heart failure patients a choice of evidence-based modes of rehabilitation delivery, including home, supported by digital technology, alongside traditional centre-based programmes (or combinations of modes, 'hybrid') and according to stage of disease and patient preference.
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Affiliation(s)
- Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, School of Health & Well Being, Clarice Pears Building, University of Glasgow, Byres Rd, Glasgow G12 8TA, UK
- Health Service Research, College of Medicine and Health, University of Exeter, Heavitree Rd, Exeter, EX2 4TH, UK
- Faculty of Health Sciences and National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Hasnain M Dalal
- University of Exeter Medical School, Royal Cornwall Hospital, Truro, UK
- Primary Care Research Group, University of Exeter Medical School, St Luke’s Campus, Exeter, UK
| | - Ann-Dorthe Zwisler
- Faculty of Health Sciences and National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark
- REHPA, Vestergade 17, 5800, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
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19
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Silva CGDSE. Is There a Role for Religion and Spirituality in Cardiac Rehabilitation? Arq Bras Cardiol 2023; 120:e20230088. [PMID: 37018792 PMCID: PMC10392855 DOI: 10.36660/abc.20230088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
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20
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Zwack CC, Haghani M, Hollings M, Zhang L, Gauci S, Gallagher R, Redfern J. The evolution of digital health technologies in cardiovascular disease research. NPJ Digit Med 2023; 6:1. [PMID: 36596833 PMCID: PMC9808768 DOI: 10.1038/s41746-022-00734-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/29/2022] [Indexed: 01/04/2023] Open
Abstract
When implemented in practice, digital technologies have shown improvements in morbidity and mortality outcomes in patients with cardiovascular disease (CVD). For scholars, research into digital technologies in cardiovascular care has been relatively recent, thus it is important to understand the history of digital health technology in cardiovascular research-its emergence, rate of growth, hot topics, and its temporal evolution. The aim of this study was to analyse more than 16,000 articles in this domain based on their scientometric indicators. Web of Science (WoS) Core Collection was accessed and searched at several levels, including titles, abstracts, keywords, authors, sources and individual articles. Analysis examined the temporal shifts in research and scholarly focus based on keywords, networks of collaboration, topical divisions in relation to digital technologies, and influential publications. Findings showed this research area is growing exponentially. Co-citation analysis revealed twenty prominent research streams and identified variation in the magnitude of activities in each stream. A recent emergence of research activities in digital technology in cardiovascular rehabilitation (CR), out-of-hospital cardiac arrest (OHCA), and arrythmia research was also demonstrated. Conversely, wearable technologies, activity tracking and electronic medical records research are now past their peak of reported research activity. With increasing amounts of novel technologies becoming available and more patients taking part in remote health care monitoring, further evaluation and research into digital technologies, including their long-term effectiveness, is needed. Furthermore, emerging technologies, which are evaluated and/or validated should be considered for implementation into clinical practice as treatment and prevention modalities for CVD.
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Affiliation(s)
- Clara C Zwack
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Milad Haghani
- School of Civil and Environmental Engineering, University of New South Wales, Sydney, Australia
| | - Matthew Hollings
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ling Zhang
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarah Gauci
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Robyn Gallagher
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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21
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Yin Ong JS, Lin W, Yeo TJ. The Role of Exercise-based Cardiac Rehabilitation in Heart Failure. Curr Pharm Des 2023; 29:494-501. [PMID: 36799421 DOI: 10.2174/1381612829666230217145100] [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: 08/01/2022] [Revised: 10/18/2022] [Accepted: 12/29/2022] [Indexed: 02/18/2023]
Abstract
Exercise-based cardiac rehabilitation (EBCR) is a treatment modality for patients with heart failure (HF) that has withstood the test of time. It has continued to show benefits even in the current era of pharmacotherapeutics for HF. Participation in a multidisciplinary comprehensive EBCR programme reduces mortality and morbidity, has a multitude of physiological benefits, and improves cardiovascular risk factor control and quality of life. Despite this, historical barriers to enrolment and uptake remain. Strategies to overcome these, as well as alternative delivery methods of EBCR in HF patients, are emerging and include telerehabilitation, focus on special groups and emphasis on behavioural change. This review provides oversight on the modalities of exercise training in HF as well as their benefits and gives an overview of barriers to the utilisation of EBCR along with future progress in the field.
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Affiliation(s)
- Jeanne Shan Yin Ong
- Cardiac Department , National University Heart Centre,1E Kent Ridge Road, Level 9, Singapore
| | - Weiqin Lin
- Cardiac Department , National University Heart Centre,1E Kent Ridge Road, Level 9, Singapore
| | - Tee Joo Yeo
- Cardiac Department , National University Heart Centre,1E Kent Ridge Road, Level 9, Singapore
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22
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Bracewell NJ, Plasschaert J, Conti CR, Keeley EC, Conti JB. Cardiac rehabilitation: Effective yet underutilized in patients with cardiovascular disease. Clin Cardiol 2022; 45:1128-1134. [PMID: 36054282 DOI: 10.1002/clc.23911] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/12/2022] Open
Abstract
Cardiac rehabilitation is a comprehensive program that treats patients with multiple cardiac conditions including post-myocardial infarction, stable angina, post-coronary artery bypass surgery, chronic heart failure, and peripheral vascular disease with structured exercise, and nutrition and risk factor counseling. It is an effective tool that has been shown to improve not only quality of life but also reduce adverse cardiac events, including death. While the value of cardiac rehabilitation is supported by a large body of evidence and its recommendation by the American Heart Association/American College of Cardiology it is significantly underutilized due to both patient and systemic factors. Continued efforts should be made to remove the obstacles to make cardiac rehabilitation available to all those who qualify.
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Affiliation(s)
- Natalie J Bracewell
- Department of Medicine, University of Florida, Gainesville, Florida, USA.,Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Jeffrey Plasschaert
- Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Charles Richard Conti
- Department of Medicine, University of Florida, Gainesville, Florida, USA.,Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Ellen C Keeley
- Department of Medicine, University of Florida, Gainesville, Florida, USA.,Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Jamie B Conti
- Department of Medicine, University of Florida, Gainesville, Florida, USA.,Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
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