Patient preferences for the delivery of cardiac rehabilitation

Secondary prevention through comprehensive cardiac rehabilitation has been recognized as the most cost-effective intervention to ensure favourable outcomes across a wide spectrum of cardiovascular disease, reducing cardiovascular mortality, morbidity and disability, and to increase quality of life. The delivery of a comprehensive and ‘modern’ cardiac rehabilitation programme is mandatory both in the residential and the out-patient setting to ensure expected outcomes. The present position paper aims to update the practical recommendations on the core components and goals of cardiac rehabilitation intervention in different cardiovascular conditions, in order to assist the whole cardiac rehabilitation staff in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and patients in the recognition of the positive nature of cardiac rehabilitation. Starting from the previous position paper published in 2010, this updated document maintains a disease-oriented approach, presenting both well-established and more controversial aspects. Particularly for implementation of the exercise programme, advances in different training modalities were added and new challenging populations were considered. A general table applicable to all cardiovascular conditions and specific tables for each clinical condition have been created for routine practice.

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“…Information on the views and preferences of the target population was derived from the literature. 11…”

Section: Background and Aimsmentioning

confidence: 99%

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Ambrosetti

Abreu

Corrà

et al. 2020

European Journal of Preventive Cardiology

525

604

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“…pohybového tréninku na základě preferencí pacienta, protože takový přístup může zajistit dlouhodobou adherenci k aktivitě. 34 Intenzitu tréninku je doporučené indikovat pouze kontinuální aerobní formou (60-80 % rezervy srdeční frekvence [HRR]), protože údaje o dálkově monitorovaném intervalovém tréninku s vysokou intenzitou (4 min 90% HRR vs. 3 min 50% HRR) jsou v současné době zatím nedostatečné. 35,36 Pacienti s ischemií myokardu nebo komorovou arytmií, vyšetřenou během zátěžových testů, by měli být z dálkově monitorovaného tréninku vyloučeni a následně předáni k ambulantně řízené KR.…”

Section: Obsah Telerehabilitačního Programuunclassified

(Cardiovascular telerehabilitation: remotely monitored physical exercise)

Baťalík

2021

Cor Vasa

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Kardiovaskulární rehabilitace (KR) představuje prostřednictvím programů založených na specializovaných nemocničních centrech účinný komplexní prvek v sekundární prevenci kardiovaskulárních onemocnění, jako jsou ischemická choroba srdeční a srdeční selhání. Komplexní KR snižuje morbiditu i mortalitu a zvyšuje kvalitu života kardiologických pacientů. Navzdory výhodám, které přináší, je účast pacientů na rehabilitačních programech nízká. Kromě nízké míry využití a dokončení programu KR nejsou u velké části pacientů s kardiovaskulárním onemocněním dosaženy cíle sekundární prevence, což představuje prostor pro zlepšení. Kardiovaskulární telerehabilitace může vyřešit několik bariér, které brání využívání programů KR. V telerehabilitaci bývá jedna nebo více složek KR poskytována mimo specializované nemocniční centrum prostřednictvím telemonitoringu, e-learningu a telekoučingu pacientů s kardiovaskulárním onemocněním. Aktuální klinické studie ukazují, že kardiovaskulární telerehabilitace je bezpečná, nákladově efektivní a účinná alternativa ve zlepšování funkční kapacity a kvality života u pacientů s ischemickou chorobou srdeční. Rozvoj a implementace kardiovaskulární telerehabilitace je obecně podporována Evropskou asociací preventivní kardiologie, obzvlášť v současné globální situaci s pandemií COVID-19 nabývá toto téma na stále větším významu.

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“…In the choice-based designs, multiple choice tasks were presented to respondents, each consisting of two or more profiles described by various attribute levels relevant to the healthcare and HIT context. Seven of the studies using choice-based designs offered an opt-out choice in which the respondent could choose none of the presented profiles (44,50,53,54,56,61,69). For example, Determann et al included an opt-out option in their DCE that explored EHR preferences in order to make the experiment resemble the real-life situation where respondents are not obligated to have a EHR (53).…”

Section: Preference Elicitation Approachesmentioning

confidence: 99%

“…The total number of choice tasks presented to respondents in a given preference study using a choicebased design ranged from 5-22 (mean 11.36, SD 4.78). Eight of these studies used blocked-designs wherein a given respondent received a subset of the total choice tasks (44,46,(48)(49)(50)52,56,69). In these studies, the total number of choice tasks ranged from 12-120.…”

Section: Preference Elicitation Approachesmentioning

confidence: 99%

Patient preferences for health information technologies: a systematic review

Crossnohere¹,

Weiss²,

Hyman³

et al. 2021

J Hosp Manag Health Policy

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Background: Advances in patient-facing health information technology (HIT) promise to improve health care delivery and patient outcomes. Low utilization of HIT suggests that the preferences of patients may not be adequately guiding the development of these technologies. This systematic review offers an assessment of published evidence regarding patient preferences for HIT.Methods: Articles addressing preferences for HIT from patient and other end-user groups published up through 2020 were identified from PubMed, Web of Science, Scopus and via hand searching. Articles that used quantitative stated-preference methods to explore preferences for HIT were eligible for inclusion.Studies that explored attitudes towards HIT without eliciting trade-offs were excluded. Critical appraisal of study quality was conducted using the PREFS checklist and quality criteria identified by the US Food and Drug Administration including heterogeneity analysis and patient engagement in study design. We conducted thematic analysis of the main preference findings from each study to synthesize patient and enduser preferences for HIT. The review was not registered and authors received no funding to conduct the review.Results: The search yielded 7,299 unique articles, 59 of which were ultimately included in the review.Studies explored preferences for telemedicine (n=30), patient portals (n=12), mHealth (n=9) or multiple HITs (n=8). Preference elicitation methods included direct elicitation (n=26), discrete-choice experiments (n=13), conjoint analysis (n=6), contingent valuation (n=5), and ranking exercises (n=9). Studies had a mean PREFS score of 3.51 out of 5. Forty-two studies conducted preference heterogeneity analysis and only 20 included patients in study design. Thematic meta-analysis indicated that patients prefer HIT that is convenient and lower cost, but does not sacrifice quality, and preferences varied by demographic features such as age as well as depending on the type of health information being communicated.Conclusions: Patient and end-users have distinct preferences for the use of HIT in their medical care.It is timely that researchers and healthcare administrators consider these preferences for HIT given its rapid uptake amidst the COVID-19 pandemic. Although this literature demonstrates that patients can be engaged as participants in preference studies to identify meaningful aspects of HIT, the field was limited in its inclusion of patients in the design of such studies. Future development of HIT should be guided by highquality preference research that integrates patients in all stages in the design and implementation of HIT.

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Patient preferences for the delivery of cardiac rehabilitation

Abstract: There is the potential to improve CR programs by focusing on patient preferences.

Cited by 34 publications

References 26 publications

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

(Cardiovascular telerehabilitation: remotely monitored physical exercise)

Patient preferences for health information technologies: a systematic review

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