Cardiac rehabilitation

2020 ◽  
pp. 371-384
Keyword(s):  
Coronary Heart Disease ◽  
Cardiac Rehabilitation ◽  
Cardiac Disease ◽  
Cardiac Event ◽  
Cardiovascular Prevention ◽  
Improvement Plan ◽  
National Service Framework ◽  
Long Time

This chapter looks at the role of cardiac rehabilitation for those at risk of cardiac disease or who have sustained a cardiac event. Cardiac rehabilitation has been a priority area for a long time in the National Service Framework for Coronary Heart Disease, NHS Improvement Plan, and now features in the NHS Long Term Plan. The introduction of certification for cardiovascular prevention and rehabilitation programmes (CPRP) has meant that their quality can be measured. The introduction of more technology-based interventions has opened up the opportunity for more people to participate, particularly for individuals who could not, or did not want to attend a traditional CPRP.

Cardiac rehabilitation

2014 ◽  
pp. 323-332
Keyword(s):  
At Risk ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Cardiac Disease ◽  
Cardiac Event ◽  
National Service ◽  
National Service Framework ◽  
Service Framework

This chapter looks at the role of cardiac rehabilitation for those at risk of cardiac disease or who have sustained a cardiac event. Cardiac rehabilitation was one of the few areas of the National Service Framework for Coronary Heart Disease where targets were not all met. It is now one of the priority areas for NHS Improvement Heart. A new pathway has been devised for cardiac rehabilitation and this is included here.

scholarly journals What to do after cardiac rehabilitation programs: the role of the general practitioner in cardiovascular prevention

2016 ◽  
Vol 86 (1-2) ◽  
Author(s):  
Margaret Cupples ◽  
Neil Heron
Keyword(s):  
Cardiac Rehabilitation ◽  
Cardiovascular Prevention ◽  
Well Being ◽  
Rehabilitation Program ◽  
Hospital Services ◽  
Rehabilitation Programs ◽  
Multidisciplinary Working ◽  
Timely Referral

<p>This paper will review the current role of general practitioners (GPs) in<strong><em> </em></strong>providing cardiovascular prevention for patients after attendance at a cardiac rehabilitation program. Long-term implementation of preventive strategies is needed for continued impact on reducing risk of cardiovascular events and GPs have a major role in providing ongoing continuing medical care. Awareness of patients’ social, cultural and physical circumstances allows the GP to identify individuals’ needs for support in engaging in secondary prevention: relevant brief interventions can promote behaviour change in physical activity, diet and smoking habits, as well as promoting mental health and adherence to optimal medical therapy. Collaborative multidisciplinary working with community and hospital services provides best opportunities for timely referral to specialist expertise to maximise patients’ well-being. </p>

Impact of Cardiac Rehabilitation on Metabolic Syndrome in Iranian Patients with Coronary Heart Disease: The Role of Obesity

2012 ◽  
Vol 37 (2) ◽  
pp. 66-73 ◽  
Author(s):  
Ali Kabir ◽  
Nizal Sarrafzadegan ◽  
Afshin Amini ◽  
Reza Safi Aryan ◽  
Fahimeh Habibi Kerahroodi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Iranian Patients

Abstract 15016: Peak Oxygen Consumption Achieved at the End of Cardiac Rehabilitation Predicts Survival in Patients With Coronary Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Salvatore Carbone ◽  
Youngdeok Kim ◽  
Sergey Kachur ◽  
Alban De Schutter ◽  
Hayley E Billingsley ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Oxygen Consumption ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Peak Oxygen Consumption ◽  
Mortality Data ◽  
Term Survival ◽  
Long Term Survival ◽  
Peak Vo2

Introduction: Several patients with coronary heart disease (CHD) present reduced survival despite completing cardiac rehabilitation (CR), suggesting that the level of cardiorespiratory fitness (CRF) achieved might remain suboptimal. The purposes of this study were: 1) to examine the independent association of peak oxygen consumption (VO 2 ), a measure of CRF, at post-CR with long-term survival; and 2) to establish an optimal cut-off for peak VO 2 at post-CR that best predicts mortality risk. Methods: 853 patients with CHD (mean age of 64±10 years old) who were referred to CR between January 1, 2000, and June 30, 2013, at Ochsner Medical Center were analyzed for this study. We measured pre- and post-CR peak VO 2 . Mortality data were collected using National Death Index. Cox proportional hazard regression model was used to examine the risk of all-cause mortality associated with peak VO 2 at post-CR, independent of peak VO 2 at pre-CR and related changes during CR. Contal and O’Quigley’s method were used to determine the optimal cut-off for peak VO 2 at post-CR based on a split-sample approach. Results: Mean peak VO 2 at post-CR was 21.01±6.25 mL/kg/min (75% and 51% predicted peak VO2 using Wasserman and FRIEND Registry equations, respectively). During a mean follow-up of 6.55 years, 106 subjects (12.4%) died. Peak VO 2 at post-CR independently predicted mortality (Hazard Ratio: 0.82 [0.77-0.87], p<0.001). We identified peak VO 2 of ≥17.6 kg/mL/min as optimal cut-off best predicting survival ( Figure 1, Panel A ) and the %predicted peak VO2 at post-CR ≥62.1% using Wasserman ( Figure 1, Panel B ) and ≥41.4% using FRIEND Registry ( Figure 1, Panel C ) as the alternative optimal cut-offs. Conclusions: In patients with CHD undergoing CR, post-CR peak VO 2 independently predicts long-term survival. These results suggest that patients with CHD presenting a peak VO 2 lower than the cut-off identified herein may benefit from additional sessions of CR or higher intensity exercise training.

The role of autonomy in explaining mental ill-health and depression among older people in long-term care settings

2005 ◽  
Vol 25 (5) ◽  
pp. 731-748 ◽  
Author(s):  
GERALDINE BOYLE
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Structured Interviews ◽  
Term Care ◽  
Domiciliary Care ◽  
Private Households ◽  
National Service Framework ◽  
The Uk

This paper examines the extent of mental ill-health and probable depression among older people in long-term care. It presents selected findings from a study in Greater Belfast, Northern Ireland, that compared the quality of life, autonomy and mental health of older people living in nursing and residential homes with those of older people living in private households who were receiving domiciliary care. Structured interviews were conducted with 214 residents in institutions and 44 older people receiving domiciliary care. The study found that those in private households were more severely physically-impaired and had a higher level of mental ill-health than the residents of institutional homes. It is suggested, however, that the mental ill-health effects were associated less with physical impairments than with the restrictions placed on the older person's decisional autonomy, and that long-term care environments that constrain the older person's autonomy contribute to the development of depression. Although the UK National Service Framework for Older People specified that those with depression should be given treatment and support, priority should also be given to preventing the depression associated with living in long-term care settings.

scholarly journals Using the Administration to Update and Evaluate Urban Planning for Cities

2021 ◽  
Vol 12 (2) ◽  
pp. 2476-2481
Author(s):  
Hadeel Mowafaaq Mahmood , Et. al.
Keyword(s):  
Urban Development ◽  
Planning Process ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Long Time ◽  
Planning Processes ◽  
The City

The planning process takes place to face a number of challenges and obstacles that address and continue for a long time to form a plan that includes the fundamental changes in society and keep pace with population and urban growth, and planning and the formation of blueprints is a basis to meet the needs of society, but the passage of time to configure it to keep pace with growth and the speed of increasing population and technical growth, it requires research studies Faster to configure a re-planning of plans and studies as an alternative to re-planning and supporting them with follow-up and continuous evaluation processes that are among the basic components of management operations, which is the solution to reduce problems and shortcomings and support for planning processes as a current and long-term treatment The role of management is important to support the planning process in the presence of evaluation and follow-up to meet the requirements of the city and its expansion Urban development and development, and looking forward to the most prominent concepts and ways that decision-makers take with techniques and methods that make the city and the services provided to it in the best image that makes the city with urban development and urban management represented by the countries.

scholarly journals The Italian Survey on Cardiac Rehabilitation - 2008 (ISYDE-2008). Part 3. National availability and organization of cardiac rehabilitation facilities. Official report of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiolog

2016 ◽  
Vol 70 (4) ◽  
Author(s):  
Roberto Tramarin ◽  
Marco Ambrosetti ◽  
Stefania De Feo ◽  
Massimo Piepoli ◽  
Carmine Riccio ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Prevention ◽  
Phase Iii ◽  
Day Hospital ◽  
Physical Medicine ◽  
Italian Association ◽  
Physical Medicine And Rehabilitation

From January 28th to February 10th 2008, the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (IACPR-GICR) conducted the ISYDE- 2008 study, the primary aim of which was to take a detailed snapshot of cardiac rehabilitation (CR) provision in Italy – in terms of number and distribution of facilities, staffing levels, organization and setting – and compare the actual CR provision with the recommendations of national guidelines for CR and secondary prevention. The secondary aim was to describe the patient population currently being referred to CR and the components of the programs offered. Out of 190 cardiac rehabilitation centers existing in Italy in 2008, 165 (87%) took part in the study. On a national basis, there is one CR unit every 299,977 inhabitants: in northern Italy there is one CR unit every 263,578 inhabitants, while in central and southern Italy there is one every 384,034 and 434,170 inhabitants, respectively. The majority of CR units are located in public hospitals (59%), the remainder in privately owned health care organizations (41%). Fifty-nine percent are located in hospitals providing both acute and rehabilitation care, 32% are in specifically dedicated rehabilitation structures, while 8% operate in the context of residential long term care for chronic conditions. Almost three-quarters of CR units currently operating are linked to dedicated cardiology divisions (74%), 5% are linked to physical medicine and rehabilitation divisions, 2% to internal medicine, and 19% to cardiac surgery and other divisions. Inhospital care is provided by 62.4% of the centers; outpatient care is provided on a day-hospital basis by 10.9% of facilities and on an ambulatory basis by 20%. The CR units are led in 86% of cases by a cardiologist and in only 14% of cases by specialists in internal medicine, geriatrics, physical medicine and rehabilitation, pneumology or other disciplines. In terms of staffing, each cardiac rehabilitation unit has 4.0±2.7 dedicated physicians (range 1-16, mode 2), 10.1±8.0 nurses, 3.3±2.5 physiotherapists (range 0 – 20; 16% of services have no physiotherapist in the rehabilitation team), 1.5±0.8 psychologists, and a dietitian (present in 62% of CR units). Phase II CR programs are available in 67.9% of cases in residential (inpatient) and in 30.9% of cases in outpatient (day-hospital and ambulatory) settings. Phase III programs are offered by 56.4% of the centers in ambulatory outpatient regime, and on an at home basis by 4.8% with telecare supervision, 7.3% without. Long term secondary prevention follow up programs are provided by 42.4% of CR services.

scholarly journals Predicting Long-Term Mortality, Morbidity, and Survival Outcomes Following a Cardiac Event: A Cardiac Rehabilitation Study

2019 ◽  
Vol 8 ◽  
pp. 117957271982761 ◽  
Author(s):  
Helen L Graham ◽  
Andrew Lac ◽  
Haeok Lee ◽  
Melissa J Benton
Keyword(s):  
Cardiac Rehabilitation ◽  
Hospital Readmission ◽  
Cardiac Event ◽  
Bypass Graft ◽  
Survival Outcomes ◽  
Prior History ◽  
Participation Rates ◽  
All Cause Mortality ◽  
History Of

Background: Cardiac rehabilitation (CR) has been shown to decrease mortality and morbidity but estimations vary. While there is significant literature supporting short-term benefits, there is not a similarly body of research as to long-term (LT) benefits. Low participation rates in CR are due to several causes and evidence demonstrating positive LT outcomes could be a catalyst to increased participation rates. Objective: To predict LT mortality, readmission, and survival benefits associated with CR participation in a nationally certified program. Methods: Investigators collected mortality and hospital readmission data in a retrospective study to examine a cohort of cardiac patients following a myocardial infarction (MI), MI/percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) up to 14 years ago. Hospital electronic medical record (EMR; n = 207) were used to measure hospital readmission outcome and State Health Department records (n = 361) for mortality and survival outcomes. Participation in CR, age, gender prior history of cardiac event, and diagnosis were used to predict readmission, mortality, and survival. Results: Approximately half (52.1%) the sample participated in CR. Participants included 72% males, average age 68 years (38-91 years), and were predominantly Non-Hispanic white. CR participants attended an average of 20 sessions. CR group differed in diagnoses MI (58.5%), CABG (57.4%) and in prior history of heart disease (25.4%) from the non-cardiac rehabilitation (NCR) group (83.2%, 25.4%, 42.2%, respectively) ( P < .05). After controlling for the covariates in logistic regression analyses, the CR group independently predicted lower all-cause mortality (odds ratio, OR = 0.22, 95% CI 0.12 to 0.39) and decreased hospital readmissions (OR = 0.48, 95% CI 0.24 to 0.96). After controlling for the covariates in survival analysis, the CR group significantly contributed to decreased likelihood of death hazard (hazard ratio = 0.36, 95% CI 0.24 to 0.54). Median survivor time for the participants was 5.91 years, SD = 3.81 years. Conclusions: Participation in CR for middle age and elderly patients is associated with increased survival, a marked decrease in all-cause mortality, and a decrease in cardiovascular-related hospital readmission. A referral to a nationally certified outpatient CR program prior to hospital discharge and early enrollment may improve LT outcomes.

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