scholarly journals Community-Based Cardiac Rehabilitation To Improves Medication Adherence in Stable Coronary Artery Disease

2020 ◽  
Vol 1 (1) ◽  
pp. 4-7
Author(s):  
Tonny Adriyanto ◽  
Cholid Tri Tjahjono ◽  
Mohammad Saifur Rohman ◽  
Sasmojo Widito ◽  
Ardian Rizal
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medication Adherence ◽  
Cardiac Rehabilitation ◽  
Stable Coronary Artery Disease ◽  
Community Based ◽  
Artery Disease

scholarly journals Effects of Community-Based Cardiac Rehabilitation on Body Composition and Physical Function in Individuals with Stable Coronary Artery Disease: 1.6-Year Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sandra Mandic ◽  
Claire Hodge ◽  
Emily Stevens ◽  
Robert Walker ◽  
Edwin R. Nye ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Body Composition ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Physical Function ◽  
Handgrip Strength ◽  
Stable Coronary Artery Disease ◽  
Community Based ◽  
Artery Disease

Objective. To examine long-term changes in physical function and body composition in coronary artery disease (CAD) patients participating in ongoing community-based cardiac rehabilitation (CR).Design. Thirty-four individuals (69.7±8.2years; 79% men) participated in this longitudinal observational study. Baseline and follow-up assessments included incremental shuttle walk, short physical performance battery, handgrip strength, chair stands, body composition, last year physical activity, and CR attendance.Results. Participants attended38.5±30.3%sessions during1.6±0.2year followup. A significant increase in 30-second chair stands (17.0±4.7to19.6±6.4,P<0.001), body weight (75.8±11.1to77.2±12.1 kg,P=0.001), and body fat (27.0±9.5to29.1±9.6%,P<0.001) and a decline in handgrip strength (36.4±9.4to33.0±10.6kg·f,P<0.001) and muscle mass (40.8±5.6to39.3±5.8%,P<0.001) were observed during followup. There was no significant change in shuttle walk duration. CR attendance was not correlated to observed changes.Conclusions. Elderly CAD patients participating in a maintenance CR program improve lower-body muscle strength but experience a decline in handgrip strength and unfavourable changes in body composition, irrespective of CR attendance.

scholarly journals Critical aspects of the management of stable coronary artery disease in primary care practice or how to increase the efficacy of evidence-based pharmacological therapy?

2020 ◽  
Vol 6 (3) ◽  
pp. 15-20
Author(s):  
Sergey K. Zyryanov ◽  
Sergey B. Fitilev ◽  
Alexander V. Vozzhaev ◽  
Irina I. Shkrebniova ◽  
Dmitry A. Klyuev
Keyword(s):  
Primary Care ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medication Adherence ◽  
Stable Coronary Artery Disease ◽  
Density Lipoprotein ◽  
Pharmacological Therapy ◽  
Care Practice ◽  
Cross Sectional ◽  
Artery Disease

Introduction: The publication describes a fragment of the pharmacoepidemiologic study conducted to review the quality of management of patients with stable coronary artery disease (SCAD) in primary care over a 12-year period. The aim of the study was to justify the application of standard operating procedures (SOPs). Such determinants of pharmacotherapy as non-pharmacological modification of cardiovascular risk factors (RFs) and medication adherence were analyzed. Material and methods: A retrospective, cross-sectional, 3-stage (2006, 2011, 2018) study was conducted in a primary care setting of Moscow. As many as 3027, 1834, 805 patients with verified diagnosis of SCAD were included. Demographics, medical history, data on modifiable RFs and prescribed drug therapies were collected. At the third stage, medication adherence was measured, using the 8-item Morisky scale. Results and discussion: Over a 7-year period, better control of modifiable RFs in coronary patients was revealed. The target levels of blood pressure were reached in 58.3% (+20.7%; p &lt; 0.05) of the patients, total cholesterol – in 33.0% (+16.0%; p &lt; 0.05), and low-density lipoprotein cholesterol – in 23.3% (+12.2%; p &lt; 0.05). Two critical problems that determined still inadequate RFs control were identified. The attention of physicians to RFs and rates of non-pharmacological interventions remained low throughout the study. Information on lifestyle RFs was recorded in fewer than one-third of the subjects. The lipid profile was registered only in half of patients’ histories. Non-adherence to pharmacotherapy was identified in 51.3% of patients. Conclusion: Further increase in efficacy of pharmacotherapy might be provided by application of SOPs regarding the registration and correction of modifiable cardiovascular RFs, identification of non-adherent patients and promotion of medication adherence.

Long-term effects of cardiac rehabilitation in elderly individuals with stable coronary artery disease

2015 ◽  
Vol 38 (9) ◽  
pp. 837-843 ◽  
Author(s):  
Sandra Mandic ◽  
Emily Stevens ◽  
Claire Hodge ◽  
Casey Brown ◽  
Robert Walker ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Stable Coronary Artery Disease ◽  
Long Term Effects ◽  
Elderly Individuals ◽  
Artery Disease

scholarly journals Effect of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed El Missiri ◽  
Walaa Adel Abdel Halim ◽  
Abdo Saleh Almaweri ◽  
Tarek Rashid Mohamed
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Stable Coronary Artery Disease ◽  
Rehabilitation Program ◽  
Obese Patients ◽  
Cardiac Rehabilitation Program ◽  
Phase 2 ◽  
Rehabilitation Programs ◽  
Artery Disease

Abstract Background Obesity is associated with significant cardiovascular morbidity and mortality effects. Cardiac rehabilitation programs cause a significant reduction in cardiovascular mortality and a reduction in all cardiovascular risk factors. Up to 80% of patients referred to cardiac rehabilitation programs are either overweight or obese. This study aimed to compare the effects of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease following total revascularization by coronary angioplasty. Results This was a prospective study including 120 patients with stable coronary artery disease. Patients were enrolled in a 12-week phase 2 cardiac rehabilitation program. Patients were classified into two groups based on their body mass index (BMI): those with a BMI < 30 kg/m2 were considered non-obese (n = 58) while those with a BMI ≥ 30 kg/m2 were considered obese (n = 62). At baseline, BMI and blood pressure (BP) were recorded; fasting blood sugar, triglyceride levels, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were assessed; and echocardiography was used to measure left ventricular ejection fraction (LVEF). These were re-assessed after completion of the program. At baseline, there were more females in the obese group 20 (32.25%) vs 6 (10.13%) (p = 0.04), more hypertensives (p = 0.023), and less smokers 32 (51%) vs 46 (79%) (p = 0.025). Obese patients achieved fewer metabolic equivalent of tasks (METs) 7.97 ± 2.4 vs 9.74 ± 2.47 (p = 0.007) and had higher LDL-C levels 121.63 ± 36.52 mg/dl vs 95.73 ± 31.51 mg/dl (p = 0.005). At the end of the program, obese patients showed more reduction in BMI − 1.78 ± 1.46 kg/m2 vs − 0. 60 ± 0.70 kg/m2 (p < 0.001) and systolic and diastolic BP (p = 0.016 and 0.038, respectively). LDL-C level was more reduced in the obese group − 25.76 ± 14.19 mg/dl vs − 17.37 ± 13.28 mg/dl (p = 0.022). Non-obese patients had more increase in LVEF (p = 0.024). There was no difference between obese and non-obese patients in the magnitude of increase in METs achieved (p = 0.21). Conclusion Cardiac rehabilitation programs lead to an improvement in cardiovascular disease risk factors with more reduction in BMI, BP, and LDL-C levels in obese patients compared to non-obese ones. LVEF was more increased in non-obese individuals. Exercise capacity in the form of METs achieved was equally improved in both groups.

scholarly journals The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study (Preprint)

2021 ◽  
Author(s):  
Boqun Shi ◽  
Xi Liu ◽  
Qiuting Dong ◽  
Yuxiu Yang ◽  
Zhongxing Cai ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medication Adherence ◽  
Stable Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Artery Disease ◽  
Multicenter Prospective Study ◽  
Level Hospital

BACKGROUND In China, ischemic heart disease is the main cause of mortality. Having cardiac rehabilitation and a secondary prevention program in place is a class IA recommendation for individuals with coronary artery disease. WeChat-based interventions seem to be feasible and efficient for the follow-up and management of chronic diseases. OBJECTIVE This study aims to evaluate the effectiveness of a tertiary A-level hospital, WeChat-based telemedicine intervention in comparison with conventional community hospital follow-up on medication adherence and risk factor control in individuals with stable coronary artery disease. METHODS In this multicenter prospective study, 1424 patients with stable coronary artery disease in Beijing, China, were consecutively enrolled between September 2018 and September 2019 from the Fuwai Hospital and 4 community hospitals. At 1-, 3-, 6-, and 12-month follow-up, participants received healthy lifestyle recommendations and medication advice. Subsequently, the control group attended an offline outpatient clinic at 4 separate community hospitals. The intervention group had follow-up visits through WeChat-based telemedicine management. The main end point was medication adherence, which was defined as participant compliance in taking all 4 cardioprotective medications that would improve the patient’s outcome (therapies included antiplatelet therapy, β-blockers, statins, and angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers). Multivariable generalized estimating equations were used to compare the primary and secondary outcomes between the 2 groups and to calculate the relative risk (RR) at 12 months. Propensity score matching and inverse probability of treatment weighting were performed as sensitivity analyses, and propensity scores were calculated using a multivariable logistic regression model. RESULTS At 1 year, 88% (565/642) of patients in the intervention group and 91.8% (518/564) of patients in the control group had successful follow-up data. We matched 257 pairs of patients between the intervention and control groups. There was no obvious advantage in medication adherence with the 4 cardioprotective drugs in the intervention group (172/565, 30.4%, vs 142/518, 27.4%; RR 0.99, 95% CI 0.97-1.02; <i>P</i>=.65). The intervention measures improved smoking cessation (44/565, 7.8%, vs 118/518, 22.8%; RR 0.48, 95% CI 0.44-0.53; <i>P</i>&lt;.001) and alcohol restriction (33/565, 5.8%, vs 91/518, 17.6%; RR 0.47, 95% CI 0.42-0.54; <i>P</i>&lt;.001). CONCLUSIONS The tertiary A-level hospital, WeChat-based intervention did not improve adherence to the 4 cardioprotective medications compared with the traditional method. Tertiary A-level hospital, WeChat-based interventions have a positive effect on improving lifestyle, such as quitting drinking and smoking, in patients with stable coronary artery disease and can be tried as a supplement to community hospital follow-up. CLINICALTRIAL ClinicalTrials.gov NCT04795505; https://clinicaltrials.gov/ct2/show/NCT04795505

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