Outcomes of cardiac rehabilitation with versus without a follow-up intervention rendered by telephone (Luebeck follow-up trial): overall and gender-specific effects

Abstract

The effects of a nurse-managed secondary prevention program for patients after acute cardiac events were examined. Special interest was given to gender-specific results. The design was a prospective, randomized, controlled trial involving 343 patients following 3 weeks of inpatient cardiac rehabilitation, randomly assigned to either of two study groups. Patients in the treatment group were contacted monthly by phone over 1 year. The main goals of the intervention were the reduction of behavioural coronary risk factors and enhancing quality of life. The program was conducted by specially trained nurses. The control group received written information only. Primary outcome was the Framingham risk score. Follow-up examination after 12 months was completed by 297 patients. Patients in the intervention group showed lower Framingham risk scores as compared to controls. Separate analyses by sex revealed that this was mostly due to the men in the sample. Women, on the other hand, showed a significant rise of clinically relevant anxiety/depressiveness in the control but not in the intervention group; in males there were no differences between study conditions. In conclusion, telephone counselling by specially trained nurses seems a cost-effective way to achieve a lasting reduction in cardiac risk factors and to maintain the effects of cardiac rehabilitation.

Treating Anxiety in Patients with Coronary Heart Disease: A Randomized Controlled Trial

“…They found a significant intervention effect that was based on a 1.5-point reduction on the HADS anxiety scale in the intervention group while anxiety scores in the control group remained stable. A similar effect was observed in another study by Mittag et al [25] in a group of 334 patients after MI or CABG. It is important to note that the intervention effects in these studies were based on stable or increasing anxiety scores in the control group compared to a decrease in the intervention group.…”

Guidelines for Rehabilitation in Patients With Cardiovascular Disease (JCS 2012)

“…To ensure successful long-term support, approaches to enhance the motivation of the participants, the continuous education by healthcare professionals, and the social support by communities are important. 335, 336 Specifically, there should be systems to provide individualized programs led by specialists with experience and expertise, useful indexes of exercise intensity and quantity, and non-hospital facilities for continued exercise training programs in communities.…”

Innovative Schulungskonzepte in der medizinischen Rehabilitation

“…[39,40]. Mittels einer klassischen Telefonnachsorge konnten in der Lübecker Nachsorgestudie positive Effekte auf das Risikoprofil von Männern mit koronarer Herzkrankheit erzielt werden [41]. Durch ein anderes telefonisches Nachsorgeprogramm, das ein Symptommonitoring durch die Patienten und eine Schulung miteinander kombinierte, konnte bei Patienten mit chronischer Herzinsuffizienz die Mortalität im ersten halben Jahr um 40% reduziert werden [42].…”