Home-Based Cardiac Rehabilitation EXPERIENCE FROM THE VETERANS AFFAIRS

被引:20
|
作者
Drwal, Kariann R. [1 ,2 ]
Wakefield, Bonnie J. [1 ,2 ,3 ]
Forman, Daniel E. [4 ,5 ,6 ]
Wu, Wen-Chih [7 ,8 ,9 ,10 ]
Haraldsson, Bjarni [1 ,2 ]
El Accaoui, Ramzi N. [1 ,11 ]
机构
[1] Vet Rural Hlth Resource Ctr Iowa City, VA Off Rural Hlth ORH, Iowa City, IA USA
[2] Iowa City VA Healthcare Syst, Ctr Access & Delivery Res & Evaluat, Iowa City, IA USA
[3] Univ Missouri, Sinclair Sch Nursing, Columbia, MO 65211 USA
[4] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA
[5] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA
[6] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA
[7] Providence VA Med Ctr, Ctr Innovat Long Term Serv & Support, Providence, RI USA
[8] Miriam Hosp, Cardiovasc Rehab Ctr, Providence, RI 02906 USA
[9] Brown Univ, Alpert Med Sch, Providence, RI 02912 USA
[10] Brown Univ, Sch Publ Hlth, Providence, RI 02912 USA
[11] Univ Iowa, Div Cardiovasc Med, Iowa City, IA USA
关键词
cardiac rehabilitation; cardiovascular disease; prevention; telehealth; CORONARY-HEART-DISEASE; QUALITY-OF-LIFE; AMERICAN-ASSOCIATION; SCIENTIFIC STATEMENT; PREVENTION PROGRAMS; CLINICAL CARDIOLOGY; EXERCISE CAPACITY; PHYSICAL-ACTIVITY; ARTERY-DISEASE; PARTICIPATION;
D O I
10.1097/HCR.0000000000000594
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: The conceptual utility of home-based cardiac rehabilitation (HBCR) is widely acknowledged. However, data substantiating its effectiveness and safety are limited. This study evaluated effectiveness and safety of the Veterans Affairs (VA) national HBCR program. Methods: Veterans completed a 12-wk HBCR program over 18 mo at 25 geographically dispersed VA hospitals. Pre- to post-changes were compared using paired t tests. Patient satisfaction and adverse events were also summarized descriptively. Results: Of the 923 Veterans with a mean age of 67.3 +/- 10.6 yr enrolled in the HBCR program, 572 (62%) completed it. Findings included significant improvements in exercise capacity (6-min walk test distance: 355 vs 398 m; P < .05; Duke Activity Status Index: 27.1 vs 33.5; P < .05; self-reported steps/d: 3150 vs 4166; P < .05); depression measured by Patient Health Questionnaire (6.4 vs 4.9; P < .0001); cardiac self-efficacy (33.1 vs 39.2; P < .0001); body mass index (31.5 vs 31.1 kg/m(2); P = .0001); and eating habits measured by Rate Your Plate, Heart (47.2 vs 51.1; P < .05). No safety issues were related to HBCR participation. Participants were highly satisfied. Conclusions: The VA HBCR program demonstrates strong evidence of effectiveness and safety to a wide range of patients, including those with high clinical complexity and risk. HBCR provides an adjunct to site-based programs and access to cardiac rehabilitation. Additional research is needed to assess long-term effects, cost-effectiveness, and sustainability of the model.
引用
收藏
页码:93 / 99
页数:7
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