Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients?

Journal article


Davidson, Patricia, Cockburn, Jill, Newton, Phillip, Webster, Julie K., Betihavas, Vasiliki, Howes, Laurie and Owensbye, Dwain O.. (2010). Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? European Journal of Preventative Cardiology. 17(4), pp. 393-402. https://doi.org/10.1097/HJR.0b013e328334ea56
AuthorsDavidson, Patricia, Cockburn, Jill, Newton, Phillip, Webster, Julie K., Betihavas, Vasiliki, Howes, Laurie and Owensbye, Dwain O.
Abstract

Background Heart failure is a common and costly condition, particularly in the elderly. A range of models of interventions have shown the capacity to decrease hospitalizations and improve health-related outcomes. Potentially, cardiac rehabilitation models can also improve outcomes.

Aim To assess the impact of a nurse-coordinated multidisciplinary, cardiac rehabilitation program to decrease hospitalizations, increase functional capacity, and meet the needs of patients with heart failure.

Method In a randomized control trial, a total of 105 patients were recruited to the study. Patients in the intervention group received an individualized, multidisciplinary 12-week cardiac rehabilitation program, including an individualized exercise component tailored to functional ability and social circumstances. The control group received an information session provided by the cardiac rehabilitation coordinator and then follow-up care by either their cardiologist or general practitioner. This trial was stopped prematurely after the release of state-based guidelines and funding for heart failure programs.

Results During the study period, patients in the intervention group were less likely to have been admitted to hospital for any cause (44 vs. 69%, P = 0.01) or after a major acute coronary event (24 vs. 55%, P = 0.001). Participants in the intervention group were more likely to be alive at 12 months, (93 vs. 79%; P = 0.03) (odds ratio =3.85; 95% confidence interval = 1.0314.42; P = 0.0042). Quality of life scores improved at 3 months compared with baseline (intervention t = 4.37, P [ 0.0001; control t= 3.52, P [0.01). Improvement was also seen in 6-min walk times at 3 months compared with baseline in the intervention group (t = 3.40; P = 0.01).

Conclusion This study shows that a multidisciplinary heart failure cardiac rehabilitation program, including an individualized exercise component, coordinated by a specialist heart failure nurse can substantially reduce both all-cause and cardiovascular readmission rates, improve functional status at 3 months and exercise tolerance.

Keywordscardiac rehabilitation; health outcomes; heart failure
Year01 Jan 2010
JournalEuropean Journal of Preventative Cardiology
Journal citation17 (4), pp. 393-402
PublisherSage journals
ISSN2047-4873
Digital Object Identifier (DOI)https://doi.org/10.1097/HJR.0b013e328334ea56
Web address (URL)https://academic.oup.com/eurjpc/article/17/4/393/5931725
Open accessPublished as non-open access
Research or scholarlyResearch
Page range393-402
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online01 Aug 2010
Publication process dates
Accepted03 Nov 2009
Deposited03 May 2024
Additional information

c 2010 The European Society of Cardiology
Copyright © Lippincott Williams & Wilkins.

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