Systematic review finds no difference between home-based and centre-based cardiac rehabilitation in terms of effect on mortality, morbidity and modifiable risk factors in patients with CHD

2010 ◽  
Vol 15 (2) ◽  
pp. 38-38 ◽  
Author(s):  
D. R. Thompson
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiac Rehabilitation ◽  
Modifiable Risk Factors ◽  
Home Based

Effectiveness of mHealth Interventions on Physical Activity and Physical Fitness in Outpatient and Home-Based Cardiac Rehabilitation Programs: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sheeba Nadarajah ◽  
Susan Buchholz ◽  
Kristen Dickins
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Cardiac Rehabilitation ◽  
Text Messaging ◽  
English Language ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Mixed Effect ◽  
Home Based

BACKGROUND Globally, cardiovascular disease is the leading cause of death. Cardiovascular mortality can be decreased by participation in cardiac rehabilitation. Researchers are exploring the use of mHealth technology in cardiac rehabilitation. OBJECTIVE The aim of this systematic review is to examine the effectiveness of randomized controlled trials that use a mHealth intervention as a part of an outpatient and/or home-based cardiac rehabilitation program on improving physical activity and physical fitness outcomes. METHODS For this systematic review, mHealth interventions were limited to text messaging, mobile apps, and use of a mobile phone network for data transmission, used to deliver cardiac rehabilitation program. Using six databases, the search strategy included published English language studies through 2016. Data was extracted independently by two reviewers, and then synthesized. RESULTS The initial search yielded 149 articles, of which 15 articles that represented nine studies met inclusion criteria. Articles were published from 2010 to 2016 and came from two continents. The majority (84%) of participants were male. Generally, the participant mean age was late 50s to early 60s. Text messaging was the most frequently used intervention. The results of the physical activity and physical fitness findings were mixed. Effect sizes for intervention as measured by the 6-minute walk test ranged from 0.46 to 0.58 and peak VO2 ranged from 0.03 to 1.35. CONCLUSIONS Globally, use of mHealth in outpatient and/or home-based cardiac rehabilitation is being studied with greater attention. However, these studies are limited by geography, gender, and age. Therefore, further research in the area of cardiac rehabilitation and mHealth is recommended, especially in developing countries, among women, and older adults.

scholarly journals Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review

2019 ◽  
Vol 7 (22) ◽  
pp. 632-632 ◽  
Author(s):  
Xi Ji ◽  
Xin-Yi Leng ◽  
Yi Dong ◽  
Ya-Hui Ma ◽  
Wei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Carotid Atherosclerosis ◽  
Meta Analysis ◽  
Modifiable Risk Factors

Global risk factors of contrast-induced acute kidney injury: systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Liu ◽  
Y Liu ◽  
S Chen ◽  
E.Y.M Chung ◽  
L Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Public Institution ◽  
Left Ventricular Ejection ◽  
Modifiable Risk Factors ◽  
Funding Source

Abstract Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China

P62 RISK FACTORS AND OUTCOMES ASSOCIATED WITH ANASTOMOTIC LEAKS (AL) FOLLOWING OESOPHAGECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
K Kamarajah Sivesh ◽  
Lin Aaron ◽  
Tharmaraja Thahesh ◽  
Bharwada Yashvi ◽  
R Bundred James ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Major Complication ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Modifiable Risk Factors ◽  
Anastomotic Leaks ◽  
Patient Counselling ◽  
Prolonged Hospital

Abstract Introduction Anastomotic leaks (AL) are a major complication after oesophagectomy. This meta-analysis aimed to determine identify risks factors for AL (pre-operative, intra-operative and post-operative factors) and assess the consequences to outcome on patients who developed an AL. Methods This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 31st December 2018. A meta-analysis was conducted with the use of random-effects modelling and prospectively registered with the PROSPERO database (Registration CRD42018130732). Results This review identified 174 studies reporting outcomes of 74,226 patients undergoing oesophagectomy. The overall pooled AL rates were 11%, ranging from 0 - 49% in individual studies. Majority of studies were from Asia (n=79). In pooled analyses, 23 factors were associated with AL (17 preoperative and six intraoperative). AL were associated with adverse outcomes including pulmonary (OR: 4.54, CI95%: 2.99 - 6.89, p<0.001) and cardiac complications (OR: 2.44, CI95%: 1.77 - 3.37, p<0.001), prolonged hospital stay (mean difference: 15 days, CI95%: 10 - 21 days, p<0.001 and in-hospital mortality (OR: 5.91, CI95%: 1.41 - 24.79, p=0.015). Conclusion AL are a major complication following oesophagectomy accounting for major morbidity and mortality. This meta-analysis identified modifiable risk factors for AL which can be a target for interventions to reduce anastomotic leak rates. Furthermore, identification of both modifiable and non-modifiable risk factors will facilitate risk stratification and prediction of AL enabling better perioperative planning, patient counselling and informed consent.

scholarly journals Implementation strategies to improve preconception and antenatal care for tobacco smoking, alcohol consumption and weight management: a systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Emma Doherty ◽  
Melanie Kingsland ◽  
Luke Wolfenden ◽  
John Wiggers ◽  
Julia Dray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Antenatal Care ◽  
Weight Management ◽  
Tobacco Smoking ◽  
Implementation Strategy ◽  
Implementation Strategies ◽  
Modifiable Risk Factors ◽  
Cochrane Central Register

Abstract Background Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors. Methods Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women’s modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively. Discussion This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women’s modifiable risk factors in preconception and antenatal care settings. Systematic review registration PROSPERO CRD42019131691

scholarly journals Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Critical Illness: A Systematic Review

2018 ◽  
Vol 93 (1) ◽  
pp. 68-82 ◽  
Author(s):  
Amra Sakusic ◽  
John C. O'Horo ◽  
Mikhail Dziadzko ◽  
Dziadzko Volha ◽  
Rashid Ali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Modifiable Risk Factors

scholarly journals Cardiovascular risk factor control: is it possible with a home-based cardiac rehabilitation program?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
NPD Cunha ◽  
I Aguiar-Ricardo ◽  
T Rodrigues ◽  
S Couto Pereira ◽  
P Silverio Antonio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Risk Factors ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Face To Face ◽  
Home Based

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular risk factors (CVRF) control, needing different strategies, through patient education, lifestyle changes and therapeutic optimization is a central core of cardiac rehabilitation. However, further studies are needed to demonstrate effectiveness of home-based Cardiac Rehabilitation (CR-HB) programs in controlling CVRF.   Purpose To evaluate the effectiveness of a CR-HB program in controlling cardiovascular risk factors. Methods Prospective cohort study including patients who were previously participating in a centre-based CR program and accepted to participate in a CR-HB program due to forced closure of the centre-based CR program for COVID-19 pandemic. The CR-HB consisted of a multidisciplinary digital CR program, including patient regular assessment, exercise, educational, and psychological and relaxation sessions. A structured online educational program for patients and family members/caregivers was provided including educational videos, and powerpoints and webinars. A real time Webinar regarding "nutritional myths and facts" was organized with the duration of 90 minutes as a substitution of the regular face-to-face regular workshop provided at our centre-based CR program. Also, self-control of blood pressure and heart rate and of glycemia in diabetics were promoted, as well as smoking cessation. To assess the impact of the CR-HB on risk factors control, all the patients were submitted to a clinical and analytical evaluation before and after the end of this at distance program.  Results 116 cardiovascular disease patients (62.6 ± 8.9 years, 95 males) who were attending a face-to-face CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease. Regarding risk factors, obesity was the most prevalent risk factor (74.7 %) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%).  Regarding the blood pressure control, 80% of the patients stated that almost daily they measured blood pressure at home; baseline systolic pressure decreased from 117 ± 13 to 113 ±12mmHg, p = 0.007, while there was no significant change in diastolic pressure.   The majority (76%) of diabetic patients said they controlled blood glucose; HbA1c decreased from 6.1 ± 1.1 to 5.9 ± 0.9mg/dL (p = 0.047). Considering the lipid profile, LDL decreased (from 75 ± 30 to 65 ± 26mg/dL, p = 0.012). The Nt-proBNP also decreased (818 ± 1332 vs 414pg/ml ± 591, p = 0.042). There were no other statistically significant differences concerning risk factors modification.  Conclusions Our study showed that a Home-based Cardiac Rehabilitation program can improve or maintain cardiovascular risk factors control, which has important prognostic implications and is frequently a difficult task to achieve.

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