Ambulatory Surveillance of Patients Referred for Cardiac Rehabilitation Following Cardiac Hospitalization: A Feasibility Study

Alter, David A.; Habot, Juda; Grace, Sherry L.; Fair, Terry; Kiernan, David; Clark, Wendy; Fell, David

doi:10.1016/j.cjca.2012.01.019

Cited by 5 publications

(4 citation statements)

References 37 publications

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“…Large UK studies showed low rates of participation (24%-40%) by eligible patients. 6,16 Furthermore, similar low rates of CR participation have been demonstrated in the US (19%-64%), 9,[17][18][19] Canada (45%-49%), 20,21 and the Netherlands (11%). 22 Current delivery models of CR, specifically during phase 2, are marred by barriers to participation related to referral, patient, and systemic factors.…”

Section: Introductionmentioning

confidence: 75%

Information and communication technology-based cardiac rehabilitation homecare programs

Varnfield¹,

Karunanithi²

2015

SHTT

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Cardiac rehabilitation (CR) has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideline recommendations, CR utilization has been poor, particularly in women, older patients, and ethnic minority groups. To overcome some of the barriers to the traditional delivery of CR, different delivery platforms and approaches have been developed in recent years. In general, Telehealth solutions which have been used to address the delivery of CR services remotely include: 1) patient-provider contact delivered by telephone systems; 2) the Internet, with the majority of patient-provider contact for risk factor management taking place online; and 3) interventions using Smartphones as tools to deliver CR through (independently or in combination with) short message service messaging, journaling applications, connected measurement devices, and remote coaching. These solutions have been shown to overcome some of the barriers in CR participation and show potential as alternative or complementary options for individuals that find traditional center-based CR programs difficult to commit to. The major benefits of remote platforms for CR delivery are the ability to deliver these interventions without ongoing face-to-face contact, which provides an opportunity to reach large numbers of people, and the convenience of selecting the timing of cardiovascular disease management sessions. Furthermore, technologies have the potential to deliver long-term follow-up, which programs delivered by health professionals cannot afford to do due to staff shortages and budget restrictions. However, change in the existing CR services is not without challenges. There is a need to identify development issues that can hamper the implementation of the interventions outside controlled trial settings systems, which may require new computing infrastructures, specific clinical responsibilities, time for training, and development and openness to new ways of doing things.

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Section: Introductionmentioning

confidence: 75%

Information and communication technology-based cardiac rehabilitation homecare programs

Varnfield¹,

Karunanithi²

2015

SHTT

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“…Our results only refer to settings offering a majority of services to persons with MSDs. Further studies are needed to address access to other kinds of rehabilitation services, since limited availability of services has also been reported for cardiac, paediatric, and poststroke rehabilitation …”

Section: Discussionmentioning

confidence: 99%

“…14 Our results only refer to settings offering a majority of services to persons with MSDs. Further studies are needed to address access to other kinds of rehabilitation services, since limited availability of services has also been reported for cardiac, 70,71 paediatric, 72 and poststroke rehabilitation. 73 In conclusion, an adequate distribution of services is necessary to achieve equitable access to health care for all the population.…”

Section: Demand To Provision Relationshipmentioning

confidence: 99%

Variations in demand and provision for publicly funded outpatient musculoskeletal physiotherapy services across Quebec, Canada

Deslauriers

Raymond

Laliberté

et al. 2017

Evaluation Clinical Practice

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“…Moreover, sicker patients may not be able to attend CR sessions as readily (e.g., HF), yet this is rarely taken into consideration when examining CR attendance. Furthermore, while CR participation is associated with fewer subsequent events, given the high rate of cardiovascular sequelae in this population as outlined above (e.g., symptoms, HF exacerbation), a non-trivial proportion of patients will experience a clinical event, particularly early in the course of CR 14 . This would render the patient unsafe for continued exercise until the clinical issue is stabilized (i.e., so-called "medical holds"), and hence they would perhaps not complete the program or participate in fewer sessions.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Rehabilitation Component Attendance and Impact of Intervening Clinical Events, as Well as Disease Severity and Risk Factor Burden

Grace

Prior

Mamataz

et al. 2021

Journal of Cardiopulmonary Rehabilitation and Prevention

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Purpose: To examine: (1) the rate of clinical events precluding cardiac rehabilitation (CR) continuation, (2) CR attendance by component in those without events, and (3) the association between disease severity (e.g., tobacco use, diabetes, and depression) and component attendance (e.g., exercise, diet, stress management, tobacco cessation).Methods: Retrospective analysis of electronic records of the CR program in London, Ontario from 1999-2017. Patients in the supervised program are offered exercise sessions twice per week, with a minimum of 48 prescribed sessions tailored to patient need. Patients attending ≥1 session without major factors that would limit their exercise ability were included. Intervening events were recorded, as was component attendance.Results: Of 5508 enrolled, supervised patients, 3696 did not have a condition that could preclude exercise. Of these, one-sixth (n=912) had an intervening event; these patients were less likely to work, more likely to have medical risk factors, had more severe angina and depression, and lower functional capacity. The remaining cohort attended a mean of 26.49±21.30 sessions overall (median=27; 19.36% attending ≥48 sessions), including 20.49±17.45 exercise sessions (median=21). After exercise, the most common components attended were individual dietary and psychological counselling. Patients with more severe angina and depressive symptoms as well as tobacco users attended significantly fewer total sessions, but more of some specific components. Conclusions: In 1/6 of patients, CR attendance and completion are impacted by clinical factors beyond their control. Many patients are taking advantage of components specific to their risk factors, buttressing the value of individually-tailored, menu-based programming.

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Ambulatory Surveillance of Patients Referred for Cardiac Rehabilitation Following Cardiac Hospitalization: A Feasibility Study

Cited by 5 publications

References 37 publications

Information and communication technology-based cardiac rehabilitation homecare programs

Information and communication technology-based cardiac rehabilitation homecare programs

Variations in demand and provision for publicly funded outpatient musculoskeletal physiotherapy services across Quebec, Canada

Cardiac Rehabilitation Component Attendance and Impact of Intervening Clinical Events, as Well as Disease Severity and Risk Factor Burden

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