Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial

Grace, Sherry L.; Midence, Liz; Oh, Paul; Brister, Stephanie J.; Chessex, Caroline; Stewart, Donna E.; Arthur, Heather M.

doi:10.1016/j.mayocp.2015.10.021

Cited by 78 publications

(110 citation statements)

References 40 publications

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“…The overall adherence was 64%. The results did not clearly favor any model (73). This study suggested that offering women alternative models for cardiac rehabilitation services did not promote adherence.…”

Section: Patient/health Care Provider Team-based Engagement Strategiesmentioning

confidence: 68%

Improving Medication Adherence in Cardiometabolic Disease

Ferdinand

Senatore

Clayton-Jeter

et al. 2017

Journal of the American College of Cardiology

132

105

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Medication nonadherence, a major problem in cardiovascular disease (CVD), contributes yearly to approximately 125,000 preventable deaths, which is partly attributable to only about one-half of CVD patients consistently taking prescribed life-saving medications. Current interest has focused on how labeling and education influence adherence. This paper summarizes the scope of CVD nonadherence, describes key U.S. Food and Drug Administration initiatives, and identifies potential targets for improvement. We describe key adherence factors, methods, and technological applications for simplifying regimens and enhancing adherence, and 4 areas where additional collaborative research and implementation involving the regulatory system and clinical community could substantially reduce nonadherence: 1) identifying monitoring methods; 2) improving the evidence base to better understand adherence; 3) developing patient/health provider team-based engagement strategies; and 4) alleviating health disparities. Alignment of U.S. Food and Drug Administration approaches to dissemination of information about appropriate use with clinical practice could improve adherence, and thereby reduce CVD death and disability.

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Section: Patient/health Care Provider Team-based Engagement Strategiesmentioning

confidence: 68%

Improving Medication Adherence in Cardiometabolic Disease

Ferdinand

Senatore

Clayton-Jeter

et al. 2017

Journal of the American College of Cardiology

132

105

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“…Further, the patient's experience with an exercise program is vital for predicting attendance (33). It is important to note, providing RPE ranges alone may not achieve the target HR ranges needed for HIIT.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Implementing High-Intensity Interval Training in Cardiac Rehabilitation Settings: A Retrospective Analysis

Way

Vidal-Almela

Keast

et al. 2020

Preprint

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Abstract Background: Cardiovascular disease is the leading cause of death worldwide. Notwithstanding the well-known benefits of cardiac rehabilitation (CR), adherence to CR remains low, particularly in women. High-intensity interval training (HIIT) has received specific attention as an emerging exercise-training paradigm that addresses frequently cited barriers to CR (i.e. lack of motivation/enjoyment and time, perceiving exercise regime as tiring/boring) and improves cardiovascular risk factors. Previous studies have examined the safety of HIIT in CR; there is little evidence on the feasibility of HIIT in CR. The aims of this study were to evaluate the feasibility of HIIT within a CR setting and examine the sex differences regarding the feasibility of such programming. Methods: Patients attended an on-site HIIT CR program (10-minute warm-up, 25 minutes of interspersed high [HI - 4 minutes at 85-95% HRpeak] and low [LO - 3 minutes at 60-70% HRpeak] intervals, 10-minute cool-down) twice weekly for 10 weeks. Heart rate (HR) and the Borg rating of perceived exertion (RPE) scale (6-20 points) were recorded at each session. Feasibility was assessed by: (1) attendance and compliance: the number of sessions attended and the compliance to the prescribed HI and LO HR ranges; (2) the patient experience: patients’ perceived effort, program difficulty, if the program was challenging and satisfying; and, (3) safety. Descriptive statistics were used to report the means and their variations. Mann-Whitney U tests and Chi-square analyses were performed to examine sex-differences. Results: A total of 151 patients (33% women, 57.5 ± 9.1 years) attended the HIIT program and completed 16±5 classes with a low attrition rate (11.3%). Most patients met or exceeded the prescribed target HR for the HI (80%) and LO (84%) intervals, respectively. Patients reported a “somewhat hard” RPE for HI (14 ± 2) and “very light” for LO (10 ± 2) intervals. All patients were satisfied with the program and found it challenging. Most patients found HIIT to be difficult (7 ± 2 points, scale range 0-10 points), yet safe (97%). Three vasovagal episodes occurred and more women dropped-out of the program than men (p<0.01). Conclusions: HIIT is a feasible, safe and well-received exercise paradigm in a CR setting.

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“…This could be due to cultural and religious factors [10]. Whether there is tailoring of women's classes to their unique needs remains a question for investigation, as is what adherence rates are achieved [32]. Programs would be prudent to focus in particular on interventions to address obesity and mental illness as these are very common CV risk factors for women in the region [33].…”

Section: Accepted Manuscript 14mentioning

confidence: 99%

Availability and delivery of cardiac rehabilitation in the Eastern Mediterranean Region: How does it compare globally?

Turk-Adawi

Supervía

Pesah

et al. 2019

International Journal of Cardiology

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Background: This study aimed to (1) confirm cardiac rehabilitation (CR) availability, (2) establish CR density and unmet need, as well as (3) the nature of programs in the Eastern Mediterranean Region (EMR), and (4) compare these (a) by EMR country and (b) to other countries. Methods: In this cross-sectional study, a survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. CR need was based on Global Burden of Disease study ischemic heart disease (IHD) estimates. Results: Of the 22 EMR countries, CR programs were identified in 12 (54.5%). Nine (75.0% country response rate) countries participated, and 24/49 (49.0% program response rate) surveys were initiated. There was 1 CR spot for every 104 incident IHD patients/year (versus 12 globally). One-third of responding programs were privately funded (n=8; versus globally p<.001), and in 18 (75.0%) programs patients paid some or all of the cost out-of-pocket (versus n=378, 36.3% globally; p<.001). Over 80% of programs accepted guideline-indicated patients. Nurses (n=20, 95.2%), cardiologists (n=18, 85.7%) and dietitians (n=18, 85.7%) were the most common healthcare providers on CR teams (mean=6.4±2.2/program; 5.9±2.8 globally, p=.18). On average, programs offered 8.9±1.7/11 core components (versus 8.7±1.9 globally, p=.90). These were most commonly initial assessment, management of risk factors, and patient education (n=21, 100.0% for each), and least commonly return-to-work counselling (n=15 71.4%). Mean dose was 27.0±13.5 sessions (versus 28.7±27.6 globally, p=.38). Seven (33.3%) programs offered some alternative models.

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Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial

Abstract: clinicaltrials.gov Identifier: NCT01019135.

Cited by 78 publications

References 40 publications

Improving Medication Adherence in Cardiometabolic Disease

Improving Medication Adherence in Cardiometabolic Disease

The Feasibility of Implementing High-Intensity Interval Training in Cardiac Rehabilitation Settings: A Retrospective Analysis

Availability and delivery of cardiac rehabilitation in the Eastern Mediterranean Region: How does it compare globally?

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