Cost-Effectiveness of Exercise-Based Cardiac Rehabilitation in Chilean Patients Surviving Acute Coronary Syndrome

Serón, Pamela; Gaete, Mónica; Oliveros, María-José; Román, Claudia; Lanas, Fernando; Velásquez, Margarita María; Reveco, Roberto; Bustos, Luís; Rojas, Ricardo

doi:10.1097/hcr.0000000000000356

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…In this way, a Chilean study evaluating the cost‐effectiveness of three different models of CR programs compared with the conventional treatment observed that regardless of the model of CR employed, all models of CR program were highly cost‐effective when compared with conventional treatment. Therefore, the inclusion of CR programs should be recommended as an important secondary prevention strategy for cardiovascular diseases [33].…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of an exercise‐based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study

Simões

Mendes

Avellar

et al. 2022

Tropical Med Int Health

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Objectives: The present study aimed to perform a cost-effectiveness analysis of an exercise-based cardiovascular rehabilitation (CR) program in patients with chronic Chagas cardiomyopathy (CCC). Methods: Cost-effectiveness analysis alongside a randomised clinical trial evaluating the effects of a 6-month exercise-based CR program. The intervention group underwent 3 weekly exercise sessions. The variation of peak oxygen consumption (VO 2peak ) was used as a measurement of clinical outcome. Cost information from all healthcare expenses (examinations, healthcare visits, medication and hospitalisation) were obtained from the medical records in Brazilian reais (R$) and transformed into dollars using the purchasing power parity ($PPP). The longitudinal costs variation was evaluated through linear mixed models, represented by β coefficient, adjusted for the baseline values of the dependent variable. The cost-effectiveness evaluation was determined through an incremental cost-effectiveness ratio using the HEABS package (Stata 15.0). Results: The intervention group presented higher costs with healthcare visits (β = +3317.3; p < 0.001), hospitalisation (β = +2810.4; p = 0.02) and total cost (β = +6407.9; p < 0.001) after 3 months of follow-up. Costs related to healthcare visits (β = +2455.8; p < 0.001) and total cost (β = +4711.4; p < 0.001) remained higher in the intervention group after 6 months. The CR program showed an incremental cost-effectiveness ratio (ICER) of $PPP 1874.3 for each increase of 1.0 ml kg À1 min À1 of VO 2peak . Conclusions: The CR program can be considered a cost-effective alternative and should be included as an intervention strategy in the care of patients with CCC.

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of an exercise‐based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study

Simões

Mendes

Avellar

et al. 2022

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…Therefore, CR has a class I recommendation from the European Society of Cardiology for the management of a cardiac ischemic event ( Anderson et al, 2016 ; Ibanez et al, 2018 ; Ji et al, 2019 ; Collet et al, 2021 ). Unfortunately, CR remains underused due to multiple reasons ( Bethell et al, 2008 ; Balady et al, 2011 ; Serón et al, 2019 ). On the one hand, many countries and regions do not have CR programs.…”

Section: Introductionmentioning

confidence: 99%

Impact of and Reasons for Not Performing Exercise Training After an Acute Coronary Syndrome in the Setting of an Interdisciplinary Cardiac Rehabilitation Program: Results From a Risk-Op- Acute Coronary Syndrome Ambispective Registry

et al. 2021

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Background and Aims: Exercise training (ET) is a critical component of cardiac rehabilitation (CR), but it remains underused. The aim of this study was to compare clinical outcomes between patients who completed ET (A-T), those who accepted ET but did not complete it (A-NT), and those who did not accept to undergo it (R-NT), and to analyze reasons for rejecting or not completing ET.Methods and Results: A unicenter ambispective observational registry study of 497 patients with acute coronary syndrome (ACS) was carried out in Barcelona, Spain, from 2016 to 2019. The primary endpoint was a composite of all-cause mortality, hospitalization for ACS, or need for revascularization during follow-up. Multivariable analysis was carried out to identify variables independently associated with the primary outcome. Initially, 70% of patients accepted participating in the ET, but only 50.5% completed it. The A-T group were younger and had fewer comorbidities. Baseline characteristics in A-NT and R-NT groups were very similar. The main reason for not undergoing or completing ET was rejection (reason unknown) or work/schedule incompatibility. The median follow-up period was 31 months. Both the composite primary endpoint and mortality were significantly lower in the A-T group compared to the A-NT and R-NT (primary endpoint: 3.6% vs. 23.2% vs. 20.4%, p < 0.001, respectively; mortality: 0.8% vs. 9.1% vs. 8.2%, p < 0.001; respectively). During multivariable analysis, the only variables that remained statistically significant with the composite endpoint were ET completion, previous ACS, and anemia.Conclusion: Completion of ET after ACS was associated with improved prognosis. Only half of the patients completed the ET program, with the leading reasons for not completing it being refusal (reason unknown) and work/schedule incompatibility. These results highlight the need to focus on the needs of patients in order to guarantee that structural barriers to ET no longer exist.

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Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study

Izawa

Kasahara

Watanabe

et al. 2021

American Heart Journal Plus: Cardiology Research and Practice

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Cost-Effectiveness of Exercise-Based Cardiac Rehabilitation in Chilean Patients Surviving Acute Coronary Syndrome

Abstract: Considering a cost-effectiveness threshold of 1 unit of gross domestic product per capita (∼$19 000), CR is highly cost-effective for the public health system in Chile.

Cited by 3 publications

References 42 publications

Cost‐effectiveness of an exercise‐based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study

Cost‐effectiveness of an exercise‐based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study

Impact of and Reasons for Not Performing Exercise Training After an Acute Coronary Syndrome in the Setting of an Interdisciplinary Cardiac Rehabilitation Program: Results From a Risk-Op- Acute Coronary Syndrome Ambispective Registry

Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study

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