EVALUATING THE COST-EFFECTIVENESS OF VIRTUAL VS. CENTER-BASED CARDIAC REHABILITATION IN VETERANS WITH ISCHEMIC HEART DISEASE

Objectives:Obesity and dyslipidemia are risk factors for ischemic heart disease, and prevention and treatment in primary care can reduce these risks. The objective of this cost-effectiveness analysis was to compare the costs and effects (in terms of life years gained) of providing nutritional counseling by a general practitioner (GP) or a dietician.Methods:A total of 60 GPs, who accepted to participate, were randomized either to give nutritional counseling or to refer patients to a dietician for counseling. The life years gained was estimated using a Cox regression model. Costs were estimated on the basis of registered use of time (dieticians) or agreed salaries (GPs).Results:The effect of nutritional counseling comparing GPs and dieticians is greatest when counseling is performed by a GP—0.0919 years versus 0.0274 years. These effects appear to be moderate, but they are significant. It is also proven that the GP group was the most cost-effective—the cost of gaining 1 extra life year was estimated to be 8,213 DKK compared with the dietician group, for which the incremental cost-effectiveness ratio was estimated to be 59,987 DKK.Conclusions:The effects were moderate, but other studies of other patient groups and interventions report effects within the same magnitude. The GP group was the most cost-effective, but it must be concluded that both counseling strategies were relatively cost-effective. Even though the cost of gaining an extra life year was estimated to be 59,987 DKK in the dietician group, this might be an acceptable price.

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Methods of Evaluation of Tolerance yo Physical Activity Based on Six-Minute Walking Test During Outpatient Rehabilitation of Patients with Ischemic Heart Disease

Physical and rehabilitation medicine, medical rehabilitation ◽

10.36425/rehab64360 ◽

2021 ◽

Vol 3 (1) ◽

pp. 4-10

Author(s):

Tatyana V. Mikhailovskaya ◽

Irina E. Mishina ◽

Olga A. Nazarova ◽

Yuri V. Dovgalyuk ◽

Julia V. Chistyakova

Keyword(s):

Physical Activity ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Cardiac Rehabilitation ◽

Ischemic Heart ◽

Outpatient Rehabilitation ◽

Walking Test ◽

Absolute Value ◽

The Absolute ◽

Predicted Values

Background.Even though the six-minute walking test is a simple and widely available tool for the evaluation of the functional capacity of cardiac patients, its interpretation is associated with some difficulties and contradictions.Aims:To evaluate the dynamics of tolerance to physical activity during outpatient rehabilitation of patients with ischemic heart disease using predicted values of distance in the six-minute walking test.Materials and methods.97 patients (70 men and 27 women, average age 59.6 [50; 60] years) after acute coronary syndrome and after myocardial revascularization were included. The six-minute walking test was performed at the beginning of the 3-weeks stage of cardiac rehabilitation and before the patients discharge. The results of the test were reported as an absolute value, a change in absolute value, and the percentage of predicted values, estimated with the reference equation by Enright and colleagues.Results.The absolute value of distance in the six-minute walking test was increased significantly from 418 [385; 465] m to 485 [440; 525] m (p0.001). The number of patients with a distance less than 300 m was decreased significantly (12 patients, 12% vs 2 patients, 2%,p0.001). In most patients, the absolute increase in distance was 30 m and more (81 people, 84%). After comparing the perceived data with the calculated predicted values, it was revealed that the distance raised from 79 [71; 82]% to 92 [88; 96]% of the predicted values. And 56 patients (58%) had a distance equal to 90% or more from its predicted value.Conclusions.During the third stage of cardiac rehabilitation the significant increase of the absolute value of the six-minute walking test, the growth of the percentage of predicted values, and the decrease of patients with a distance less than 300 m were found. All these estimation methods may be used to demonstrate and prove favourable changes of tolerance to physical activity in patients with ischemic heart disease.

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GENDER RESPONSE OF PATIENTS WITH ISCHEMIC HEART DISEASE FOLLOWING A SIX-WEEK CARDIAC REHABILITATION PROGRAM

Medicine & Science in Sports & Exercise ◽

10.1249/00005768-199205001-00960 ◽

1992 ◽

Vol 24 (Supplement) ◽

pp. S160

Author(s):

L. Szmedra ◽

D. Bacharach ◽

D. Enrich ◽

D. Hermann ◽

L. LeMura ◽

...

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Cardiac Rehabilitation ◽

Rehabilitation Program ◽

Ischemic Heart ◽

Cardiac Rehabilitation Program

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Is Cardiac Rehabilitation Equally Effective in Improving Dietary Intake in All Patients with Ischemic Heart Disease?

Journal of the American College of Nutrition ◽

10.1080/07315724.2020.1755910 ◽

2020 ◽

pp. 1-8

Author(s):

Ulla Bach Laursen ◽

Martin Nygård Johansen ◽

Albert Marni Joensen ◽

Kim Overvad ◽

Mogens Lytken Larsen

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Dietary Intake ◽

Cardiac Rehabilitation ◽

Ischemic Heart

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Cost-Effectiveness of ICD Implantation in Clinical Settings Different From Ischemic Heart Disease: What Do We Know?

Cardiac Arrhythmias 2003 ◽

10.1007/978-88-470-2137-2_66 ◽

2004 ◽

pp. 505-510

Author(s):

G. Boriani ◽

M. Biffi ◽

C. Martignani ◽

C. Greco ◽

C. Camanini ◽

...

Keyword(s):

Heart Disease ◽

Cost Effectiveness ◽

Ischemic Heart Disease ◽

Ischemic Heart ◽

Clinical Settings ◽

Icd Implantation

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Effects of short and long term cardiac rehabilitation on physical capacity, blood lipids, behavioral characteristics in men with ischemic heart disease

Atherosclerosis ◽

10.1016/s0021-9150(00)81233-2 ◽

2000 ◽

Vol 151 (1) ◽

pp. 272

Author(s):

I. Kubacka ◽

J. Tylka ◽

M. Kowalska ◽

S. Rudnicki ◽

K. Mazurek

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Cardiac Rehabilitation ◽

Blood Lipids ◽

Physical Capacity ◽

Ischemic Heart ◽

Behavioral Characteristics ◽

Short And Long Term

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Comparison of the effect of 12- and 24-session cardiac rehabilitation on physical, psychosocial and biomedical factors in ischemic heart disease patients

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2019-0023 ◽

2020 ◽

Vol 41 (1) ◽

Author(s):

Masoumeh Sadeghi ◽

Abdullah Izadi ◽

Mohammad Mahdi Hadavi ◽

Mohammad Rafati Fard ◽

Hamidreza Roohafza

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Cardiac Rehabilitation ◽

Ischemic Heart ◽

Life Questionnaire ◽

Short Term ◽

Significant Difference

AbstractBackgroundCardiac rehabilitation (CR) is a key component of effective care for patients with a wide spectrum of cardiac problems. It seems that the short-term provision of these services can facilitate their use and meeting of related needs for patients participating in the CR programs.Materials and methodsIn this interventional study on patients with ischemic heart disease (IHD) referred to the Cardiac Rehabilitation Center of Chamran Hospital, Isfahan, Iran. One-hundred and twelve patients were randomly divided into two groups of 12 and 24 sessions of CR [mean age: 59.2 ± (9.02) and 60.7 ± (9.3) years, respectively] and underwent a CR program. All information was collected in two stages, before the beginning of the program and after completion of 12- and 24-session rehabilitation programs. The data collection tools were demographics questionnaire, the International Physical Activity Questionnaires (IPAQ), McNew Quality of Life Questionnaire, Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS).ResultsThe results of this study showed that in both groups, total physical activity (PA) and functional capacity increased, and the quality of life (QOL) was statistically improved. Comparison of changes in mean differences at the end of the rehabilitation periods between the two groups, showed that only the weight, body mass index (BMI), waist circumference (WC) and high-density lipoprotein (HDL) in the 24-session group significantly decreased compared to the 12-session group and, but no significant difference in other variables was observed.ConclusionOverall, the findings of this study support the overall benefits of the CR program in both the short and the long term. Therefore it can be suggested that a short-term program can still be a valuable option for reducing the risk in cardiac patients and meeting their service needs.

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