Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease

Clark, Alexander M.; Hartling, Lisa; Vandermeer, Ben; McAlister, Finlay A.

doi:10.7326/0003-4819-143-9-200511010-00010

Cited by 832 publications

(627 citation statements)

References 89 publications

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“…Meta‐analyses suggested that CR participation can reduce all‐cause mortality by 15% to 28% for patients with MI4, 37, 38, 39 and 45% to 47% for patients with percutaneous coronary intervention 40. The effect was estimated to be comparable to improvements associated with aspirin, β‐blocker, angiotensin‐converting enzyme inhibitor, statin, and anticoagulant therapy 5, 41, 42, 43.…”

Section: Discussionmentioning

confidence: 99%

Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long‐Term Mortality

Fonarow

Mukamal

et al. 2018

JAHA

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BackgroundCardiac rehabilitation (CR) referral is recommended for eligible patients, regardless of sex or race. It is unclear whether inequality in CR referral practices was associated with patients’ long‐term survival.Methods and ResultsWe linked the American Heart Association Get With The Guidelines Coronary Artery Disease registry with Medicare claims data for 48 993 coronary artery disease patients from 365 hospitals across the United States between 2003 and 2009. We used generalized estimation equations to estimate the association between CR referral and mortality accounting for clustering within hospitals. Between 2003 and 2009, only 40% of eligible patients received CR referrals. Females were 12% less likely to receive CR referral compared with males. Black, Hispanic, and Asian patients were 20%, 36%, and 50% less likely, respectively, to receive CR referral than white patients. CR referral was associated with 40% lower 3‐year all‐cause mortality. Women and minorities who received CR referral at hospital discharge had significantly lower mortality compared with those who did not (odds ratios=0.61 [95% confidence interval, 0.56–0.66] for women, 0.75 [95% confidence interval, 0.63–0.88] for black, 0.62 [95% confidence interval, 0.50–0.79] for Hispanic, and 0.63 [95% confidence interval, 0.46–0.85] for Asian patients). Seven percent of the black versus white mortality gap could potentially be reduced by equitable CR referral.Conclusions CR referral rates at hospital discharge remained low. Gaps in receiving CR referral at hospital discharge were large for women and minorities, and the mortality gap could potentially be reduced through elimination of inequality in CR referral.

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Section: Discussionmentioning

confidence: 99%

Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long‐Term Mortality

Fonarow

Mukamal

et al. 2018

JAHA

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“…[10][11][12][13][14] These all report a lower all-cause mortality and death rate from cardiovascular causes in the arms who received CR rather than usual care. The reviews differ in which groups found statistically significant reductions in mortality.…”

Section: Effectiveness Of Cardiac Rehabilitationmentioning

confidence: 99%

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

Jolly¹,

Taylor²,

Gy³

et al. 2007

Health Technol Assess

174

262

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email.Paying by official purchase order You can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA The Birmingham Rehabilitation Uptake Maximisation Study (BRUM NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as royal colleges and NHS trusts. These suggestions are carefully prioritised by panels of independent experts (including NHS service users). The HTA Programme then commissions the research by competitive tender. Secondly, the HTA Programme provides grants for cl...

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“…As initially shown in the study by Framinhgham (3) and confirmed in subsequent studies, risk factors are ubiquitous in the world, in different racial and ethnical groups, and is closely linked to the lifestyles of populations. It has been proven that the control of risk factors through specific programs results in reduced morbidity and mortality due to cardiovascular diseases and due to all other causes (4)(5)(6) . A metanalysis revealed that regardless of strategies used to control risk factors, that is, whether the programs focus on educational strategies, physical conditioning or combined interventions, the results obtained are similar (6) .…”

Section: Introductionmentioning

confidence: 99%

“…It has been proven that the control of risk factors through specific programs results in reduced morbidity and mortality due to cardiovascular diseases and due to all other causes (4)(5)(6) . A metanalysis revealed that regardless of strategies used to control risk factors, that is, whether the programs focus on educational strategies, physical conditioning or combined interventions, the results obtained are similar (6) . Given the magnitude of the problem related to CVDs in the Brazilian context, it is important that nurses use a conceptual structure that enables the planning and the assessment of interventions intended to reverse this situation through the control of risk factors and illness management.…”

Section: Introductionmentioning

confidence: 99%

Conceptual framework for research and clinical practice concerning cardiovascular health-related behaviors

Gallani

Cornélio²,

Agondi³

et al. 2013

Rev. Latino-Am. Enfermagem

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Objective: To present a conceptual framework based on the PRECEDE model conceived to guide research and the clinical practice of nurses in the clinical follow-up of patients with cardiovascular diseases. Method: The conceptual bases as well as the study designs used in the framework are discussed. The contextualization of the proposed structure is presented in the clinical follow-up of hypertensive patients. Examples of the intervention planning steps according to the intervention mapping protocol are provided. Results: This conceptual framework coherently and rationally guided the diagnostic steps related to excessive salt intake among hypertensive individuals, as well as the development and assessment of specific interventions designed to change this eating behavior. Conclusion: The use of this conceptual framework enables a greater understanding of health-related behaviors implied in the development and progression of cardiovascular risk factors and is useful in proposing nursing interventions with a greater chance of success. This model is a feasible strategy to improve the cardiovascular health of patients cared for by the Brazilian Unified Health System. Estrutura conceitual para pesquisa e prática clínica na mudança de comportamentos em saúde cardiovascular Objetivo: apresentar a estrutura conceitual baseada no modelo PRECEDE, para guiar a pesquisa e a prática clínica do enfermeiro, na abordagem do paciente cardiopata ao longo de seu seguimento clínico. Método: as bases conceituais, assim como os desenhos metodológicos de pesquisa, implicados na estrutura conceitual, são abordados. A seguir, a contextualização da estrutura proposta é ilustrada no seguimento clínico de pacientes hipertensos, com incorporação das etapas de planejamento de intervenções, segundo o protocolo intervention mapping.Resultados: constata-se que a utilização dessa estrutura conceitual permitiu guiar, de modo coerente e racional, as etapas diagnósticas relacionadas ao consumo excessivo de sal entre os hipertensos, bem como norteou o desenvolvimento e avaliação de intervenções específicas para mudança desse comportamento alimentar. Conclusão: a utilização da estrutura conceitual proposta permite compreensão mais ampla dos comportamentos em saúde, implicados no desenvolvimento e progressão dos fatores de risco cardiovascular, assim como revela-se um caminho interessante para a proposição de intervenções de enfermagem, com maior chance de sucesso. O emprego dessa estrutura, de modo ampliado, pode constituir um meio factível para melhorar a saúde cardiovascular dos pacientes atendidos pelo Sistema Único de Saúde.Descritores: Comportamento; Planejamento em Saúde; Educação em Saúde; Enfermagem. Modelo conceptual para la investigación y la práctica clínica en los cambios de comportamiento en salud cardiovascularObjetivo: presentar el marco conceptual basado en el modelo PRECEDE, concebido para orientar la investigación y la práctica clínica de las enfermeras para el seguimiento clínico de pacientes cardíacos. Método: La base conceptual, así...

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Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease

Abstract: A wide variety of secondary prevention programs improve health outcomes in patients with coronary disease.

Cited by 832 publications

References 89 publications

Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long‐Term Mortality

Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long‐Term Mortality

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

Conceptual framework for research and clinical practice concerning cardiovascular health-related behaviors

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