Employment status three years after percutaneous coronary intervention and predictors for being employed: A nationwide prospective cohort study

Abstract

Background: Vocational support is recommended for patients in cardiac rehabilitation (CR), as returning to work is important in patients social readjusting after an acute coronary event. Information is lacking on whether CR leads to higher long-term employment after percutaneous coronary intervention (PCI). Aims: The aims of this study were to determine employment status three years after PCI, to compare employment status between CR participants and CR non-participants and to assess predictors for employment. Methods: We included first-time PCI patients from the NorStent trial, who were of working age (<63 years; n = 2488) at a three-year follow-up. Employment status and CR participation were assessed using a self-report questionnaire. Propensity score method was used in comparing employment status of CR participants and CR non-participants. Results: Seventy per cent of participants who were <60 years of age at the index event were employed at follow-up and CR participation had no effect on employment status. Being male, living with a partner and attaining higher levels of education were associated with a higher chance of being employed, while being older, prior cardiovascular morbidity and smoking status were associated with lower chance of being employed at follow-up. Conclusion: Because a significant number of working-age coronary heart disease patients are unemployed three years after coronary revascularization, updated incentives should be implemented to promote vocational support. Such programmes should focus on females, patients lacking higher education and patients who are living alone, as they are more likely to remain unemployed.

The Effectiveness of Case-management Rehabilitation Intervention in Facilitating Return to Work and Maintenance of Employment After Myocardial Infarction: Results of a Randomized Controlled Trial

“…No difference was found between the study groups in the participation rates in cardiac rehab programs. No or little effect of cardiac rehab enrollment on employment status was observed in many other studies; 6,28 and was also the overall finding of Hegewald et al 27 who conducted a systematic review of 39 randomized controlled trials that aimed to evaluate the effects of interventions intended to enhance return-to-work in patients with coronary heart disease compared to usual vs. no care. To illustrate, they found that person-directed combined interventions, applying both psychological counseling and physical conditioning versus usual care, may have increased return-to-work for up to six months.…”

“…Not unexpected, the employment rate of patients in the control group, is very similar to that observed in other studies in which typically short-term cardiac rehabilitation was employed. 4,6,26 The success of the comprehensive case-management program in facilitating long-term maintenance of employment may be explained, in addition to the factors mentioned above, by containing other components of disability management/vocational rehabilitation programs, suggested by rehabilitation specialists as important for enhancing work re-integration, namely: occupational counseling, monitoring and providing support and alleviating any difficulties during work reintegration, addressing personal and work related-obstacles that might affect an individual's decision to return-to-work, and providing coordination between all relevant parties. 6,7,27,28 The majority of the participants in this study participated in a regular cardiac rehab program (see Methods).…”

“…Not unexpected, the employment rate of patients in the control group, is very similar to that observed in other studies in which typically short-term cardiac rehabilitation was employed. 4 , 6 , 26 …”

“…Nearly a quarter of the patients may be detached from employment due to cardiac and non-cardiac reasons. 2 After 2-3 years from the event, about 70-76% of patients are employed [4][5][6] and only 64% of those still employed, are working full time. 4 Mounting evidence suggests that vocational reintegration of cardiac patients is not necessarily associated with cardiac functions but rather determined by demographic (e.g.…”

Factors influencing return to work 3 months after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease: A single-center, cross-sectional study

“…A study of 3291 patients with CHD in 24 European countries found that 76% of patients could return to work within 6 months to 3 years after discharge [ 9 ]. A prospective cohort study carried out by Norwegian scholars found that approximately 89% of patients returned to work 3 years after PCI [ 11 ]. The results of a questionnaire survey conducted by Wang on 428 patients 3 years after PCI revealed that 5.7% of patients were unable to work or had serious health problems at work, and 58.8% of patients had a significant decrease in work level and needed to reduce their work hours [ 12 ].…”