scholarly journals Early results on the efficacy and acceptability of a cardiac rehabilitation programme that transitioned to a fully virtual platform with adoption of wearable technology for covid era

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S B Connolly ◽  
J L Jones ◽  
C Jennings ◽  
L Neubeck ◽  
D A Wood
Keyword(s):  
Blood Pressure ◽  
Cardiac Rehabilitation ◽  
Patient Reported Outcomes ◽  
Smoking Habit ◽  
Wearable Technology ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme ◽  
Face To Face ◽  
Patient Reported ◽  
Virtual Platform

Abstract Background/Introduction Cardiaovascular prevention/rehabilitation programmes continue to reduce cardiovascular mortality even with contemporary treatment. During covid the majority of face-to-face programmes were suspended but these services have never been more crucial as control of cardiovascular risk factors can mitigate the morbidity/mortality risk from covid. Programmes must now however be delivered in a way that reduces patient exposure. Here we describe how we rapidly transitioned our previously fully face to face cardiovascular prevention/programme to a completely virtual platform adopting Fitbit as wearable technology. Methods The previously face-to-face initial assessment (IA) conducted by the multidisciplinary team (MDT) – nurse, dietician and physiotherapist is now delivered via video/phone as per patient preference. Patients are provided with equipment kits (tape measures, blood pressure monitors (BP), Fitbit smartwatches and Fibricheck app as required. The virtual IA includes assessment of: Smoking habit, blood pressure (BP), heart rate, lipid profile and HbA1c (taken in community phlebotomy hub), cardioprotective medications, weight, BMI, waist circumference, Mediterranean Diet Score, functional capacity via the Duke Activity Status Index, habitual activity levels, risk stratification for exercise, hospital anxiety and depression scores (HADS) and quality of life (QOL). Patients receive education and tailored advice with SMART goals as well as a written care plan. The subsequent 12 programme is comprised of Results Between April and November 2020 n=262 had a virtual IA (94% of those offered and n=114 (95% of those offered) attended an end of programme assessment. 64% were male and the mean age was 64.1 years. Acceptance of the Fitbit device was 72% of those offered. Table 1 below shows the main clinical and patient-reported outcomes in those attending both an IA and EOP with the data for the same 6 months the year prior (face to face programme) also for comparison. Programme satisfaction ratings were high with 85% rating the programme as excellent or very good. Conclusions Transitioning a previously fully face to face cardiac rehabilitation programme to a wholly virtual platform was feasible and acceptable to patients. Early data analysis would suggest that the virtual programme achieves similar clinical and patient reported outcomes. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Funded under Transformation Funding Programme, Department of Health, Northern Ireland Table 1

Impact of a paediatric cardiac rehabilitation programme upon patient quality of life

2021 ◽  
pp. 1-8
Author(s):  
Kristin H. Kroll ◽  
Joshua R. Kovach ◽  
Salil Ginde ◽  
Roni M. Jacobsen ◽  
Michael Danduran ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Psychosocial Functioning ◽  
Rehabilitation Programme ◽  
Self Concept ◽  
Cardiac Rehabilitation Programme ◽  
Patient Reported ◽  
Related Quality

Abstract Introduction: Cardiac rehabilitation programmes for paediatric patients with congenital heart disease (CHD) have been shown to promote emotional and physical health without any associated adverse events. While prior studies have demonstrated the effectiveness of these types of interventions, there has been limited research into how the inclusion of psychological interventions as part of the programme impacts parent-reported and patient-reported quality of life. Materials and methods: Patients between the ages of 7 and 24 years with CHD completed a cardiac rehabilitation programme that followed a flexible structure of four in person-visits with various multidisciplinary team members, including paediatric psychologists. Changes in scores from the earliest to the latest session were assessed regarding exercise capacity, patient functioning (social, emotional, school, psychosocial), patient general and cardiac-related quality of life, patient self-concept, and patient behavioural/emotional problems. Results: From their baseline to final session, patients exhibited significant improvement in exercise capacity (p = 0.00009). Parents reported improvement in the patient’s emotional functioning, social functioning, school functioning, psychosocial functioning, cognitive functioning, communication, and overall quality of life. While patients did not report improvement in these above areas, they did report perceived improvement in certain aspects of cardiac-related quality of life and self-concept. Discussion: This paediatric cardiac rehabilitation programme, which included regular consultations with paediatric psychologists, was associated with divergent perceptions by parents and patients on improvement related to quality of life and other aspects of functioning despite improvement in exercise capacity. Further investigation is recommended to identify underlying factors associated with the differing perceptions of parents and patients.

Validity and test-retest reliability of a patient-reported outcome measure for an outpatient cardiac rehabilitation programme

2019 ◽  
Vol 14 (8) ◽  
pp. 1-13
Author(s):  
Aynsley Cowie ◽  
Mario Hair ◽  
Emma Kerr ◽  
Janet McKay ◽  
Lesley Allan ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Concurrent Validity ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme ◽  
Retest Reliability ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Test Retest Reliability

Background/Aims This article details how a patient-reported outcome measure (PROM), termed PROM-CR1, was tested for acceptability, validity and test-retest reliability at the end of an outpatient cardiac rehabilitation programme. Methods PROM-CR1 was completed by 138 service users (mean age 66.95 years, range 42–94 years; 115 males, 23 females; with a range of cardiac diagnoses), who used the tool at home twice: once at the end of the outpatient cardiac rehabilitation programme and 1 week later. Results PROM-CR1 demonstrated good acceptability, construct and concurrent validity, and test-retest reliability. The construct validity analysis highlighted that one item required removal from the PROM-CR1. Conclusions A finalised 30-item version of the tool will now be widely disseminated and further evaluated within cardiac rehabilitation clinical practice.

Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
S Mcgaffin ◽  
M Taggart ◽  
D Smyth ◽  
D O"doherty ◽  
J Brown ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Psychosocial Health ◽  
Nursing Intervention ◽  
Rehabilitation Programme ◽  
Self Report ◽  
Initial Assessment ◽  
Face To Face ◽  
Weekly Meeting ◽  
Patient Reported ◽  
Virtual Platform

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Our Hearts Our Minds Purpose Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme. Background The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era.  Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme Methods Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided) Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs Bimonthly virtual coaching consultation for monitoring/goal resetting Bimonthly group video education sessions Results From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date.  Of the completed IA’s 257 were willing to attend the programme (98% uptake).  120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below. The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face. Conclusion Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service. Table 1 below exhibits the clinical and patient-reported outcomes.

scholarly journals Delivering a dietetic intervention to cardiovascular patients in the Covid era

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Rodgers ◽  
W Edwards ◽  
J Garrity ◽  
D Latimer ◽  
D Wilson ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Cardiac Rehabilitation ◽  
Mediterranean Diet ◽  
Public Institution ◽  
Anthropometric Measures ◽  
Cardiac Rehabilitation Programme ◽  
Group Education ◽  
Face To Face ◽  
The Mediterranean ◽  
Virtual Platform

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Department of Health Introduction Healthy diet and body composition are core components of cardiac rehabilitation. Following the COVID outbreak in March 2020, our face-to-face cardiac rehabilitation programme (Our Hearts Our Minds) was suspended. The programme was then quickly moved to a virtual platform to continue to deliver the programme. Purpose Here we describe how the OHOM programme adapted our service to deliver the dietetic assessment and intervention on a virtual platform. Methods Pre-Covid the dietary component of OHOM consisted of a face-to-face Initial Assessment (IA) with a dietitian, group education sessions and an End of Programme assessment (EOP). Anthropometric measures and dietary habits were assessed including adherence to the Mediterranean diet via the Mediterranean Diet Score (MDS) toolkit. Using behaviour change techniques, tailored dietary advice was provided and goals agreed to educate on healthier food choices, increase adherence to Mediterranean diet and (if appropriate) promote weight loss and reduce central obesity. The assessment and intervention is now delivered virtually via telephone or video. Anthropometrics are self-reported with tape-measures supplied to assess waist circumference and advice provided on home-weighing. MDS is still assessed. The programme includes fortnightly coaching telephone consultations to review and reset goals, the option to attend a dietitian-led virtual group education session, access to a filmed educational video and submission of food diaries via the Fitbit app. Results From April to November 2020, 114 patients completed the virtual programme (65 telephone, 39 video). Dietetic outcomes are outlined in Table 1 with inclusion of data for a similar period one year previously (face-to-face) for comparison. Reductions in anthropometric measures and increased adherence to a cardio-protective diet were noted and the results for the two time periods are remarkably similar. Conclusion Delivery of a virtual dietetic component in cardiac rehabilitation is feasible, acceptable and just as effective as face-to-face based on preliminary data. Table 1: Dietary outcomes at IA and EOP Face-to-face assessments (April - March 2019) Virtual assessments (April - November 2020) IA EOP Change IA EOP Change Mean weight (in those with BMI >25kg/m2) 86.5 85.2 -1.3 91.4 88.6 -2.8 Waist circumference (cm) 104.3 103 -1.3 107 102 -5 Mean MDS (Range 1-14) 4.4 7.5 +3.1 4.8 7.8 +3 % Consuming oily fish once per week 20 57 +37 25 68 +43 Achieving fruit and vegetable target 16 61 +45 21 57 +36 Abstract Figure. Dietitian waist circumference tutorial

Patient perceptions of experience with cardiac rehabilitation after isolated heart valve surgery

2017 ◽  
Vol 17 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Tina B Hansen ◽  
Selina K Berg ◽  
Kirstine L Sibilitz ◽  
Ann D Zwisler ◽  
Tone M Norekvål ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Heart Valve ◽  
Isolated Heart ◽  
Personal Responsibility ◽  
Training Programme ◽  
Valve Surgery ◽  
Rehabilitation Programme ◽  
Heart Valve Surgery ◽  
Structured Interviews ◽  
Cardiac Rehabilitation Programme

Background: Little evidence exists on whether cardiac rehabilitation is effective for patients after heart valve surgery. Yet, accepted recommendations for patients with ischaemic heart disease continue to support it. To date, no studies have determined what heart valve surgery patients prefer in a cardiac rehabilitation programme, and none have analysed their experiences with it. Aims: The purpose of this qualitative analysis was to gain insight into patients’ experiences in cardiac rehabilitation, the CopenHeartVR trial. This trial specifically assesses patients undergoing isolated heart valve surgery. Methods: Semi-structured interviews were conducted with nine patients recruited from the intervention arm of the trial. The intervention consisted of a physical training programme and a psycho-educational intervention. Participants were interviewed three times: 2–3 weeks, 3–4 months and 8–9 months after surgery between April 2013 and October 2014. Data were analysed using qualitative thematic analysis. Results: Participants had diverse needs and preferences. Two overall themes emerged: cardiac rehabilitation played an important role in (i) reducing insecurity and (ii) helping participants to take active personal responsibility for their health. Despite these benefits, participants experienced existential and psychological challenges and musculoskeletal problems. Participants also sought additional advice from healthcare professionals both inside and outside the healthcare system. Conclusions: Even though the cardiac rehabilitation programme reduced insecurity and helped participants take active personal responsibility for their health, they experienced existential, psychological and physical challenges during recovery. The cardiac rehabilitation programme had several limitations, having implications for designing future programmes.

A COMPREHENSIVE CARDIAC REHABILITATION PROGRAMME

1968 ◽  
Vol 2 (12) ◽  
pp. 511-513
Author(s):  
John H. Aloes ◽  
Severin Grabin ◽  
Seymour P. Stein
Keyword(s):  
Cardiac Rehabilitation ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme

P1743Assessment of quality of care of patients with ST-segment elevation myocardial infarction in Poland

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Hudzik ◽  
A Budaj ◽  
M Gierlotka ◽  
A Witkowski ◽  
W Wojakowski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Quality Of Care ◽  
Cardiac Rehabilitation ◽  
Quality Indicators ◽  
Medical Therapy ◽  
Patient Reported Outcomes ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Patient Reported

Abstract Introduction 2017 ESC Guidelines for the management of ST-elevation myocardial infarction (STEMI) patients have called for the assessment of the quality of care to establish measurable quality indicators in order to ensure that every patient with STEMI receives the best possible care. We investigated the quality indicators of health care services in Poland provided to STEMI patients. Methods The Polish Registry of Acute Coronary Syndromes (PL-ACS) is an ongoing, nationwide, multicenter, prospective, observational study of consecutively hospitalized patients with the whole spectrum of ACS in Poland. For the purpose of assessing quality indicators, we included 8,279 patients from the PL-ACS Registry hospitalized with STEMI between January 1 and December 31, 2018. Results All emergency medical services (EMS) are equipped with ECG/defibrillators. 408 of 8,279 patients (4.9%) arrived at PCI center by self-transport, 4,791 patients (57.9%) patients arrived at PCI center by direct EMS transport, and 2,900 patients (37.2%) were transferred from non-PCI facilities. Whilst 95.1% of STEMI patients arriving in the first 12 hours received reperfusion therapy, the rates of timely reperfusion were much lower (ranging from 39.4% to 55.0% for various STEMI pathways). 7,807 patients (94.3%) underwent PCI as a mode of primary reperfusion strategy. The median left ventricular ejection fraction (LVEF) was 46% and was assessed before discharge in 86.0% of patients. 489 of 8,279 patients (5.9%) died during hospital stay. Optimal medical therapy is prescribed in 50–85% of patients depending on various clinical settings. Only one in two STEMI patient is enrolled in a cardiac rehabilitation program at discharge. No patient-reported outcomes were recorded in the PL-ACS Registry. Figure 1 Conclusions The results of this study identified areas of healthcare systems that require solid improvement. These include prehospital ECG decision strategy, direct transport to PCI center, timely reperfusion, guidelines-based medical therapy (in particular in patients with heart failure), referral to cardiac rehabilitation/secondary prevention programs. More importantly, we recognized an urgent need for the initiation of recording quality indicators associated with patient-reported outcomes.

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