Referral and participation in cardiac rehabilitation of patients following acute coronary syndrome: lessons learned
Autor: | Loes van Winden, Saskia L.M.A. Beeres, Henk J. van Exel, Martin J. Schalij, Nicole van Keulen, Sander F. Rodrigo |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
DBC
Diagnosis treatment combination (Diagnose behandel combinatie) medicine.medical_specialty Acute coronary syndrome Referral Cardiac rehabilitation ACS Acute coronary syndrome Quality of life Internal medicine CR Cardiac rehabilitation medicine SES Socio-economic status Diseases of the circulatory (Cardiovascular) system Myocardial infarction Patient participation Original Paper CVA Cerebrovascular accident CI Confidence interval business.industry Unstable angina Secondary prevention Odds ratio TIA Transient ischemic attack medicine.disease EPD Electronic patient dossier Confidence interval STEMI ST-elevation myocardial infarction NSTEMI Non ST-elevation myocardial infarction RC666-701 LV Left ventricular Cardiology and Cardiovascular Medicine business OR Odds ratio |
Zdroj: | IJC HEART & VASCULATURE, 36. ELSEVIER IRELAND LTD International Journal of Cardiology: Heart & Vasculature, Vol 36, Iss, Pp 100858-(2021) International Journal of Cardiology. Heart & Vasculature |
Popis: | Highlights • A clinical care track including CR referral results in a high CR participation rate. • CR referral is lower in older and non-STEMI patients. • A larger distance to the CR center is associated with a lower CR participation rate. Purpose Cardiac rehabilitation (CR) after hospitalization for acute coronary syndrome (ACS) has shown to reduce mortality, readmissions, and improve quality of life. CR is recommended by international guidelines but previous studies have shown low participation rates. Systematic CR referral might improve CR participation. Methods The present study evaluates CR referral and CR participation of patients hospitalized for ACS in 2017 and treated according to local protocol, which includes systematic CR referral. Participation rate was divided into a group that finished the CR program and drop outs. In addition, factors associated with CR referral and participation rate were evaluated. Results A total of 469 patients eligible for CR were included in the study, of which 377 (80%) were referred for CR and 353 (75%) participated in CR. Ninety percent of participants completed the CR program. Factors independently associated with CR referral included age (50–60 year vs. > 70 year: odds ratio [OR] 4.7, 95% confidence interval [CI] 1.98–11.2), diagnosis (ST-elevation myocardial infarction vs. unstable angina: OR 17.7, CI 7.59–41.7), previous cardiovascular disease (OR 0.4, CI 0.19–0.73) and left ventricular dysfunction vs. normal function (OR 2.2, CI 1.11–4.52). A larger distance to the CR center was associated with lower CR participation ( 20 km: OR 3.1, CI 1.20–7.72). Conclusions Systematic CR referral in ACS patients results in high CR referral (80%) and participation (75%) rates. CR adherence might be further improved by increasing CR referral, especially in older patients and patients with NSTEMI or unstable angina. |
Databáze: | OpenAIRE |
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