Cardiac rehabilitation for heart failure: Do older people want to attend and are they referred?

Buttery, Amanda K.; Carr‐White, Gerald; Martin, Finbarr C.; Glaser, Karen; Lowton, Karen

doi:10.1016/j.eurger.2014.04.011

Cited by 11 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the United States, Akosah et al found that compared to those who saw primary care doctors, participants referred to specialized HF clinics were younger (68 years compared with 76 years) 28 . In the United Kingdom, participants with HF referred were found to be about 5 years younger as well 41 Findings from Sweden were also consistent 45 …”

Section: Resultsmentioning

confidence: 95%

Referral and access to heart function clinics: A realist review

Fowokan

Frankfurter

Dobrow

et al. 2020

Evaluation Clinical Practice

View full text Add to dashboard Cite

Rationale, aim, and objectives Heart failure (HF) clinics are highly effective, yet not optimally utilized. A realist review was performed to identify contexts (eg, health system characteristics, clinic capacity, and siting) and underlying mechanisms (eg, referring provider knowledge of clinics and referral criteria, barriers in disadvantaged patients) that influence utilization (provider referral [ie, of all appropriate and no inappropriate patients] and access [ie, patient attends ≥1 visit]) of HF clinics. Methods Following an initial scoping search and field observation in a HF clinic, we developed an initial program theory in conjunction with our expert panel, which included patient partners. Then, a literature search of seven databases was searched from inception to December 2019, including Medline; Grey literature was also searched. Studies of any design or editorials were included; studies regarding access to cardiac rehabilitation, or a single specialist for example, were excluded. Two independent reviewers screened the abstracts, and then full‐texts. Relevant data from included articles were used to refine the program theory. Results A total of 29 papers from five countries (three regions) were included. There was limited information to support or refute many elements of our initial program theory (eg, referring provider knowledge/beliefs, clinic inclusion/exclusion criteria), but refinements were made (eg, specialized care provided in each clinic, lack of patient encouragement). Lack of capacity, geography, and funding arrangements were identified as contextual factors, explaining a range of mechanistic processes, including patient clinical characteristics and social determinants of health as well as clinic characteristics that help to explain inappropriate and low use of HF clinics (outcome). Conclusion Given the burden of HF and benefit of HF clinics, more research is needed to understand, and hence overcome sub‐optimal use of HF clinics. In particular, an understanding from the perspective of referring providers is needed.

show abstract

Section: Resultsmentioning

confidence: 95%

Referral and access to heart function clinics: A realist review

Fowokan

Frankfurter

Dobrow

et al. 2020

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Twelve studies (8%) focused on preferences for certain healthcare services, and specifically (1) preferred care processes (10/12),45 135–143 such as continuity of care, accessibility and acceptance of the substitution of a physician by nurses and (2) service models (2/12),31 144 perhaps asking patients about their preferences regarding Chronic Care Model recommendations 31…”

Section: Resultsmentioning

confidence: 99%

Health-related preferences of older patients with multimorbidity: an evidence map

et al. 2019

View full text Add to dashboard Cite

ObjectivesTo systematically identify knowledge clusters and research gaps in the health-related preferences of older patients with multimorbidity by mapping current evidence.DesignEvidence map (systematic review variant).Data sourcesMEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Science Citation Index/Social Science Citation Index/-Expanded from inception to April 2018.Study selectionStudies reporting primary research on health-related preferences of older patients (mean age ≥60 years) with multimorbidity (≥2 chronic/acute conditions).Data extractionTwo independent reviewers assessed studies for eligibility, extracted data and clustered the studies using MAXQDA-18 content analysis software.ResultsThe 152 included studies (62% from North America, 28% from Europe) comprised 57 093 patients overall (range 9–9105). All used an observational design except for one interventional study: 63 (41%) were qualitative (59 cross-sectional, 4 longitudinal), 85 (57%) quantitative (63 cross-sectional, 22 longitudinal) and 3 (2%) used mixed methods. The setting was specialised care in 85 (56%) and primary care in 54 (36%) studies. We identified seven clusters of studies on preferences: end-of-life care (n=51, 34%), self-management (n=34, 22%), treatment (n=32, 21%), involvement in shared decision making (n=25, 17%), health outcome prioritisation/goal setting (n=19, 13%), healthcare service (n=12, 8%) and screening/diagnostic testing (n=1, 1%). Terminology (eg, preferences, views and perspectives) and concepts (eg, trade-offs, decision regret, goal setting) used to describe health-related preferences varied substantially between studies.ConclusionOur study provides the first evidence map on the preferences of older patients with multimorbidity. Included studies were mostly conducted in developed countries and covered a broad range of issues. Evidence on patient preferences concerning decision-making on screening and diagnostic testing was scarce. Differences in employed terminology, decision-making components and concepts, as well as the sparsity of intervention studies, are challenges for future research into evidence-based decision support seeking to elicit the preferences of older patients with multimorbidity and help them construct preferences.Trial registration numberOpen Science Framework (OSF): DOI 10.17605/OSF.IO/MCRWQ.

show abstract

“…Golwala et al, found patients who were referred to CR were younger, more likely to be male, and had fewer comorbid conditions. Buttery et al, (2014) found 72% of HF patients aged 65 years and older preferred to attend CR, yet only 21% were referred. However, individuals over the age of 65 are the largest cohort of individuals living with HF and represent the population that may benefit most from CR with access to multidisciplinary services to assist with the increased co-morbidities associated with this age group (Golwala et al, 2015;Grace et al, 2009).…”

Section: Cardiac Rehabilitation and Heart Failurementioning

confidence: 99%

Demographic and clinical characteristics of individuals’ Intentions to attend cardiac rehabilitation following hospitalization for heart failure: a descriptive analysis

Cunningham¹

2021

Preprint

View full text Add to dashboard Cite

There is limited literature available that addresses heart failure patient attendance at cardiac rehabilitation centers. This quantitative descriptive pilot study used a convenience sample (n=30) to determine differences in socio-demographic and clinical characteristics and complications among individuals with heart failure who intended or did not intend to attend cardiac rehabilitation six weeks post-discharge. Findings suggest those intending to attend were significantly (p<0.05) older, unemployed/retired, received an income >$50,000, were able to drive, had lower functional classification scores, and experienced fewer complications over six weeks post-discharge. This descriptive pilot study provides an understanding of factors associated with intention to attend cardiac rehabilitation as well as the feasibility of the study design and procedures. Implications focus on strategies to increase potential attendance at cardiac rehabilitation in the heart failure population at the health care provider, organizational and policy levels as well as areas for future research.

show abstract

Cardiac rehabilitation for heart failure: Do older people want to attend and are they referred?

Cited by 11 publications

References 28 publications

Referral and access to heart function clinics: A realist review

Referral and access to heart function clinics: A realist review

Health-related preferences of older patients with multimorbidity: an evidence map

Demographic and clinical characteristics of individuals’ Intentions to attend cardiac rehabilitation following hospitalization for heart failure: a descriptive analysis

Contact Info

Product

Resources

About