Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs

Бубнова, М. Г.

doi:10.15829/1728-8800-2020-2649

Cardiovasc Ther Prev

2020

DOI: 10.15829/1728-8800-2020-2649

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Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs

М. Г. Бубнова

Abstract: The review discusses the participation of patients with coronary artery disease after acute myocardial infarction and revascularization surgeries in cardiac rehabilitation (CR) and secondary prevention programs. The problems of patients not being included in rehabilitation programs and the reasons for low adherence to these programs are considered. The contribution of non-drug therapy to achievement of CR and secondary prevention goals is discussed. Various strategies are proposed for involving and increasing … Show more

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Cited by 4 publications

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Dynamics of adherence to treatment and quality of life in patients with prosthetic heart valves who participated in the educational programs (10-year follow-up)

Горбунова

Рожнев

Lyapina

et al. 2022

Kompleks. probl. serdečno-sosud. zabol.

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Highlights. Patient education program developed for patients with prosthetic heart valves, which includes information on the anticoagulant therapy, prevention of prosthetic valve endocarditis, and physical and psychological rehabilitation, helps to improve adherence to treatment and quality of life immediately upon completion of training (6 months). The quality of life and adherence to treatment were higher at 10-year follow-up in patients undergoing full course of training, in inpatient and outpatient settings, compared with patients undergoing training in inpatient setting only.Aim. To evaluate the efficacy of the training program for patients with prosthetic heart valves in improving treatment adherence and quality of life at 10-year follow-up.Methods. Patient education program entitled “School for patients with prosthetic heart valves” was developed and implemented at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo) in 2010. The program provides knowledge and training regarding anticoagulant therapy, prevention of prosthetic valve endocarditis, physical and psychological rehabilitation. The training group consisted of 92 patients who completed a full course of training (6 months). The control group included 56 patients who completed training in inpatient setting only. Long-term efficacy of the developed education program was assessed at 10-year follow-up via evaluation of the indicators of adherence to treatment (questionnaire for determining the integral indicator of adherence to treatment (IIAT)) and the quality of life (using Short-Form 36-item questionnaire (SF-36)).Results. Initially, data analysis showed no statistically significant differences between the groups in the quality of life and adherence to treatment. Six months later the IIAT score in the training group (full course of training) was 9.15±1.16, in controls the score was 6.20±1.05 (р = 0.0001). Highest IIAT scores in the training group remained similar (8.10±1.20 points) at 10-year follow-up, in the control group it was lower - 5.19±1.09 (р = 0.0001). After 6 months, physical component summary score increased by 24% over baseline in controls (р = 0.0001) and by 25% in the training group (р = 0.0001). After 6-month follow-up, there was an improvement in the psychological component summary score by 14.5% (р = 0.0001) in the control group and by 42.8% in the training group (р = 0.0001). 10 years after completion of training, physical component and mental component summary scores were higher in patients undergoing full training course - 8.3% (р = 0.0001) and 14.3% (р = 0.0001), respectively.Conclusion. Patient education program “School for patients with prosthetic heart valves” via full course of training increases levels of adherence to treatment and quality of life mainly due to improvement of psychological component summary score in the early period (6 months) and at 10-year follow-up.

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Dynamics of adherence to treatment and quality of life in patients with prosthetic heart valves who participated in the educational programs (10-year follow-up)

Горбунова

Рожнев

Lyapina

et al. 2022

Kompleks. probl. serdečno-sosud. zabol.

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Dynamics of anxiety, depression, and quality of life after early physical rehabilitation of patients who underwent surgical correction of acquired mitral valve defect: clinical prospective randomized study

et al. 2023

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BACKGROUND: The activation of the patient from the day after an acquired mitral valve (MV) defect with standard cardiorehabilitation surgery and further physical training at an early uncomplicated inpatient stage of the postoperative period appears promising to improve not only the functional status but also the quality of life (QL). AIM: Our aim was to examine the effect of early physical rehabilitation on the dynamics of anxiety, depression, and QL in patients after surgical correction of the MV defect. MATERIALS AND METHODS: The study included 80 patients (median age 60.8 [47.5; 69.0] years) who underwent surgical correction of an acquired MV defect. Starting from the 7th day after the surgery, patients were assessed for functional status, and the intensity of the training load was selected, and this was done again on the 24th day after the surgery. Moreover, the QL parameters on the SF-36 scale and levels of anxiety and depression on the Hospital Anxiety and Depression Scale (HADS) were evaluated. The control group (n=47) underwent a standard cardiac rehabilitation program from 1st day after surgery. In the main group (n=33), based on the results of the cardiopulmonary exercise testing, physical training on a treadmill was initiated for 14 days, from the 8th day after the surgery, in addition to a personalized training program. RESULTS: In addition to improving the functional state, early physical training improved the dynamics of QL indicators in the main group. After 14 days of treadmill training, the physical health component increased from a median of 35.1 to 64.4 (p=0.03), and the mental health component from a median of 49.1 to 82.1 (p=0.03). In addition, after the early physical rehabilitation program in the main group, the number of people without anxiety and depression, according to the HADS scale, significantly increased from 9% to 27.3% (p=0.04), whereas the dynamics of the QL, anxiety, and depression levels in the control group were not significant. CONCLUSION: Early physical rehabilitation, including moderate-intensity workouts with an individual calculation of the speed / angle of the treadmill, starting from 8 days after surgical correction of the acquired MV defect demonstrated efficacy in improving the QL and reducing anxiety and depression levels 24 days after surgery.

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The Efficacy of the Smart-Rehabilitation Program in Patients After the Correction of Valvular Heart Diseases

et al. 2023

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Aim Comparative analysis of the effectiveness of a new approach, "SMART rehabilitation of patients after heart valve replacement", which includes, in addition to face-to-face training, Internet technologies in the form of video conferencing, the mobile application "Calculation of the warfarin dose", and a traditional program for educating patients after correction of valvular defects.Material and methods The study included 190 patients with prosthetic heart valves. The main group consisted of 98 patients who completed a distance learning course. The control group included 92 patients participating in face-to-face training. Clinical and instrumental examinations (electrocardiography, echocardiography, determination of international normalized ratio (INR)), and surveys to evaluate awareness, compliance with treatment, and quality of life (QoL) were performed.Results At baseline, the awareness, compliance and QoL did not differ between the compared groups. After 6-month follow-up, the mean score of awareness increased by 53.6 % (р=0.0001). The compliance with treatment increased 3.3 times in the main group and 1.7 times in the control group (p=0.0247). Patients of the main group were more prone to self-management (p=0.0001), had better medical and social awareness (p=0.0335), medical and social communicability (p=0.0392), confidence in the therapeutic strategy of the attending physician (p=0.0001), and treatment effectiveness (p=0.0057). Analysis of QoL showed increases in living activity 2.1 times (р=0.0001), social functioning 1.6 times (р=0.0001), and mental health 1.9 times (р=0.0001).Conclusion The novel approach of distance learning, "SMART rehabilitation of patients after heart valve replacement", provides improvements in awareness, compliance with treatment and QoL.

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Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs

Cited by 4 publications

References 47 publications

Dynamics of adherence to treatment and quality of life in patients with prosthetic heart valves who participated in the educational programs (10-year follow-up)

Dynamics of adherence to treatment and quality of life in patients with prosthetic heart valves who participated in the educational programs (10-year follow-up)

Dynamics of anxiety, depression, and quality of life after early physical rehabilitation of patients who underwent surgical correction of acquired mitral valve defect: clinical prospective randomized study

The Efficacy of the Smart-Rehabilitation Program in Patients After the Correction of Valvular Heart Diseases

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