Cardiac rehabilitation costs

Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L.

doi:10.1016/j.ijcard.2017.06.030

Cited by 29 publications

(28 citation statements)

References 66 publications

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“…Despite various benefits of exercise-based CR, a very few facilities are offering outpatient (Phase II and III) CR in India 15 with a participation rate of just 13% 16 . This underutilization of outpatient CR program might be because of the low-income group,15, 17, 18, 19 low education,17, 18 time and distance constraints, 15 and poor awareness and referral by cardiologists for CR in middle-income countries such as India 17, 20. Most of these limitations can be overcome by using simple, safe, realistic, cost-effective, home-based, and self-monitored CR programs to increase participation, adherence, and completion of outpatient CR 15, 21, 22, 23, 24, 25.…”

Section: Introductionmentioning

confidence: 99%

The talk test—A costless tool for exercise prescription in Indian cardiac rehabilitation

Saini

Kulandaivelan

Devi

et al. 2018

Indian Heart Journal

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Exercise-based cardiac rehabilitation (CR) plays a vital role in improving function and preventing mortality of cardiovascular disease (CVD) patients. Outpatient (Phase II and III) CR is almost nonexistent in India because of several reasons such as time, cost, distance, education level, scarcity of resources and so forth. Cardiologists or cardiac surgeons can directly advise patients and their family members to do an optimal dose of exercise in low-resource settings, that is, rural, low-income, or low-educated patients. Talk test is a no-cost, subjective tool for exercise prescription which is gaining popularity in CR because of its simplicity. This brief descriptive review covers history, administration, physiological mechanisms, reliability and validity, and safety among cardiac patients along with limitations of the ‘talk test’. This review also theoretically discusses how the talk test could be used in primary and secondary prevention of CVD. Finally, it advocates Indian CR team to use this simple validated tool as a self-monitoring tool of exercise intensity.

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Section: Introductionmentioning

confidence: 99%

The talk test—A costless tool for exercise prescription in Indian cardiac rehabilitation

Saini

Kulandaivelan

Devi

et al. 2018

Indian Heart Journal

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“…CBCR referral is a health care quality performance metric [ 5 , 6 ], yet for three decades, only 10% to 20% of eligible women have attended CBCR, with up to a 56% dropout rate [ 7 - 18 ]. CBCR underutilization stems from numerous intrapersonal, interpersonal, logistical, programmatic, and health system barriers [ 19 , 20 ]. Inadequate health insurance and copayments of up to US $250 per session deter women from CBCR participation [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…CBCR-eligible patients given the choice between HBCR and CBCR are up to four times more likely to participate in HBCR [ 40 - 42 ]. Compared with CBCR, HBCR overcomes logistical barriers to access, the need for expensive facilities, specialized exercise equipment, and high personnel costs and provides education, coaching, and monitoring by a health coach through, when available, wearable sensors and smartphones that are potentially operational 24 hours a day, 7 days a week [ 20 , 43 ]. Moreover, HBCR assesses daily PA, whereas CBCR only measures supervised exercise sessions [ 44 ].…”

Section: Introductionmentioning

confidence: 99%

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study

Sengupta¹,

Beckie²,

Dutta³

et al. 2020

JMIR Form Res

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Background Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care. Objective The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants. Methods Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment. Results All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04). Conclusions The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

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“…In recent years, home-based CR has been gradually accepted as an alternative to the more traditional center-based CR. Evidence has been accumulated that home-based CR programs are often as effective as center-based CR programs [ 12 - 15 ], and they may incur lower costs [ 16 , 17 ] (but see [ 18 ]). A practical barrier for traditional CR is also eliminated as patients can stay at home and contact doctors or trainers through information and communication technologies (ICTs) only when necessary.…”

Section: Introductionmentioning

confidence: 99%

Promoting Physical Activity With Self-Tracking and Mobile-Based Coaching for Cardiac Surgery Patients During the Discharge–Rehabilitation Gap: Protocol for a Randomized Controlled Trial

Zhang¹,

Hamad²,

Robijns³

et al. 2020

JMIR Res Protoc

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Background Home-based cardiac rehabilitations (CRs) with digital technologies have been researched and implemented to replace, augment, and complement traditional center-based CR in recent years with considerable success. One problem that technology-enhanced home-based CR can potentially address is the gap between cardiac interventions and formal CR programs. In the Netherlands and some other countries (eg, Australia), patients after cardiac interventions stay at home for 3-4 weeks without much support from their physicians, and often engage in very little physical activity (PA). A home-based exercise program enabled by digital technologies may help patients to better prepare for the later center-based CR programs, potentially increasing the uptake rate of those programs. Objective In a randomized controlled trial (RCT), we will evaluate the effectiveness of a home-based walking exercise program enhanced by self-tracking and mobile-based coaching (treatment condition), comparing it with a version of the same program without these technologies (control condition). The added value of the digital technologies is justified if patients in the treatment group walk more steps on average (primary outcome) and show better physical fitness in a bicycle ergometer test and higher self-efficacy toward PA (secondary outcomes). Methods Based on a power analysis, we will recruit 100 cardiac patients and assign them evenly to the 2 parallel groups. Eligible patients are those who are scheduled in the postanesthesia care unit, know the Dutch language, have basic literacy of using smartphones, and are without medical conditions that may increase risks associated with PA. In a face-to-face meeting with a nurse practitioner, all patients are prescribed a 3-week exercise program at home (2 walking exercises per day with increasing duration), based on national and international guidelines and tailored to their physical conditions after cardiac intervention. Their physical activities (daily steps) will be measured by the Axivity AX3 accelerometer worn at hip position. Patients in the treatment group will also be supported by a Neo Health One self-tracking device and a mobile platform called Heart Angel, through which they are monitored and coached by their nurses. After the study, all patients will perform a bicycle ergometer test and return the devices within 1 week. In addition, 5 questionnaires will be sent to the patients by emails to assess their self-efficacy toward PA and other psychological states for exploratory analyses (at discharge, at the end of each monitoring week, and 1 week after the study). To minimize bias, the randomization procedure will be performed after introducing the exercise program, so the nurse practitioners are blind to the experimental conditions until that point. Results The study protocol has been approved by the Medical Research Ethics Committees United on February 26, 2018 (NL 62142.100.17/R17.51). By the end of 2018, we completed a small pilot study with 8 patients and the results based on interviews and app usage data suggest that a larger clinical trial with the targeted population is feasible. We expect to complete the RCT by the end of 2021, and statistical analyses will follow. Conclusions Results of the RCT will help us to test the hypothesized benefits of self-tracking and mobile-based coaching for cardiac patients in home-based exercise programs during the discharge–rehabilitation gap. If the results are positive, cost-effectiveness analysis will be performed based on the insights of the study to inform the translation of the technology-enhanced program to clinical practice. We also note limitations of the trial in the discussion. Trial Registration Registered at Netherlands Trial Register NL8040; https://www.trialregister.nl/trial/8040 International Registered Report Identifier (IRRID) PRR1-10.2196/16737

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Cardiac rehabilitation costs

Cited by 29 publications

References 66 publications

The talk test—A costless tool for exercise prescription in Indian cardiac rehabilitation

The talk test—A costless tool for exercise prescription in Indian cardiac rehabilitation

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study

Promoting Physical Activity With Self-Tracking and Mobile-Based Coaching for Cardiac Surgery Patients During the Discharge–Rehabilitation Gap: Protocol for a Randomized Controlled Trial

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