Community-Based Cardiac Rehabilitation Maintenance Programs: Use and Effects

Mandic, Sandra; Body, Dianne; Barclay, Leanne; Walker, Robert; Nye, Edwin R.; Grace, Sherry L.; Williams, Michael J.A.

doi:10.1016/j.hlc.2015.01.014

Cited by 17 publications

(15 citation statements)

References 26 publications

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“…Currently, a very small percentage of eligible CAD patients participate in maintenance CR programs [4]. In addition, there is a paucity of information regarding maintenance CR programs despite findings that such programs are associated with health benefits and facilitate management of cardiovascular risk factors [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…In individuals with cardiovascular disease participating in community-based maintenance CR programs, session attendance was positively correlated with peak oxygen consumption and first-year attendance was strongly correlated with attendance in subsequent years [24]. Therefore, understanding the reasons for attendance and non-attendance of maintenance CR programs is essential for promoting longterm exercise adherence in graduates of outpatient CR programs and facilitating their transition to maintenance CR programs.…”

Section: Discussionmentioning

confidence: 99%

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Examining Motivations and Barriers for Attending Maintenance Community-Based Cardiac Rehabilitation Using the Health-Belief Model

Horwood

Williams

Mandic

2015

Heart, Lung and Circulation

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Examining Motivations and Barriers for Attending Maintenance Community-Based Cardiac Rehabilitation Using the Health-Belief Model

Horwood

Williams

Mandic

2015

Heart, Lung and Circulation

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“…They are also shown to be efficacious [104][105][106][107] . The offering of alternative models was first reported in a 1997 publication from England and Wales 25 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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“…For example, Liebs et al showed that aquatic therapy in patients following knee replacement had the effect size of nonsteroidal anti‐inflammatory medications in management of continuing osteoarthritis. Similarly, Mandic et al showed that a community‐based cardiac rehabilitation program improved survival and decreased both hospitalizations and required procedures in patients with cardiovascular disease. Maintenance programs for diabetics have focused on the most common complications such as ophthalmic and foot issues, which were influenced by the patient's age, health literacy, behavioral assessment, and economic situation .…”

mentioning

confidence: 96%

“…In medicine, recall and maintenance protocols have been increasingly emphasized to manage and improve patient health outcomes . Human lifespans are increasing, and management of chronic diseases and associated morbidities has increased the emphasis on patient‐centered management of professionally directed recall and maintenance programs . For example, Liebs et al showed that aquatic therapy in patients following knee replacement had the effect size of nonsteroidal anti‐inflammatory medications in management of continuing osteoarthritis.…”

mentioning

confidence: 99%

A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 1: Tooth‐Borne Restorations

Daubert

García

Gauthier

et al. 2015

Journal of Prosthodontics

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Purpose To evaluate the current scientific evidence on patient recall and maintenance of dental restorations on natural teeth, standardize patient care regimens, and improve maintenance of oral health. An additional purpose was to examine areas of deficiency in the current scientific literature and provide recommendations for future studies. Materials and Methods An electronic search for articles in the English language literature from the past 15 years was performed independently by multiple investigators using a systematic search process. After application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed in depth to meet the objectives of this review. Results The initial electronic search resulted in 2161 titles. The systematic application of inclusion and exclusion criteria resulted in 12 articles that met the objectives of the study. An additional 4 articles were added through a supplemental search process for a total of 16 studies. Out of these, 9 were randomized controlled clinical trials and 7 were observational studies. The majority of the studies (14 out of 16) were conducted in the past 5 years, and most of the studies were conducted in Europe (10). Results from the qualitative data, on a combined 3569 patients, indicated that outcome improvements in recall and maintenance regimen were related to (1) patient/treatment characteristics (adherence to recall appointments, type of restoration and type of restorative material); (2) agent (chlorhexidine, fluoride, triclosan); and (3) professional interventions (repeated oral hygiene instruction, regular oral hygiene intervention). Conclusions There is minimal evidence related to recall regimens in patients with removable and fixed tooth‐borne restorations; however, there is considerable evidence indicating that patients with tooth‐borne removable and fixed restorations require lifelong dental professional maintenance to provide repeated oral hygiene instruction and regular oral hygiene intervention customized to each patient's treatment. Current evidence also indicates that use of specific oral topical agents like chlorhexidine, fluoride, and triclosan can aid in reducing risk for gingival inflammation, dental caries, and candidiasis. Therefore, these agents may aid in improvement of professional and at‐home maintenance of various tooth‐borne dental restorations. Furthermore, due to the heterogeneity of patient populations, restorations, and treatment needs, the evidence compels forethought of creating clinical practice guidelines for recall and maintenance of patients with tooth‐borne dental restorations.

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Community-Based Cardiac Rehabilitation Maintenance Programs: Use and Effects

Abstract: Participation in community-based CR maintenance programs is associated with health benefits but these programs are not accessed by a diversity of patients.

Cited by 17 publications

References 26 publications

Examining Motivations and Barriers for Attending Maintenance Community-Based Cardiac Rehabilitation Using the Health-Belief Model

Examining Motivations and Barriers for Attending Maintenance Community-Based Cardiac Rehabilitation Using the Health-Belief Model

A Review of Cardiac Rehabilitation Delivery Around the World

A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 1: Tooth‐Borne Restorations

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