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[Long-term effects of rehabilitation of an outpatient "heart group". A case control study]
G Buchwalsky1, R Buchwalsky, K Held
1Deutsche Gesellschaft für Prävention und Rehabilitation von Herz-Kreislauferkrankungen e.V. (DGPR), Friedrich-Ebert-Ring 38 56058 Koblenz, Germany. buchwalsky@t-online.de
Insights
Out-of-hospital cardiac rehabilitation in heart groups (HG) significantly improved exercise tolerance and quality of life in patients post-myocardial infarction and CABG. This program reduced cardiac complaints, medication needs, morbidity, and healthcare costs.
Area of Science:
- Cardiology
- Public Health
- Rehabilitation Medicine
Background:
- Cardiac rehabilitation programs are crucial for post-myocardial infarction (MI) and coronary artery bypass grafting (CABG) patients.
- Out-of-hospital programs offer an alternative to traditional center-based cardiac rehabilitation.
- The effectiveness of community-based cardiac rehabilitation in "heart groups" (HG) requires further investigation.
Purpose of the Study:
- To evaluate the long-term effects of an out-of-hospital cardiac rehabilitation program delivered through "heart groups" (HG).
- To compare outcomes between patients participating in HG and a matched control group (KG) after MI and CABG.
Main Methods:
- A case-control study design was employed.
- 75 patients in the HG were matched with 75 patients in the KG from a large rehabilitation clinic cohort.
- Follow-up was conducted over 7.5 years.
Main Results:
- No significant difference in risk factor modification was observed between groups.
- HG participants showed a significant 50% increase in maximum work capacity, indicating improved exercise tolerance.
- HG members reported fewer cardiac complaints, reduced need for cardiac medication, a 54% decrease in cardiac morbidity, and a 47% reduction in healthcare costs.
Conclusions:
- Out-of-hospital cardiac rehabilitation in heart groups can significantly improve exercise tolerance and quality of life, even in older individuals.
- While risk factor modification was insufficient, the program effectively reduced cardiac morbidity and associated healthcare expenditures.
- Heart group programs represent a cost-effective model for secondary cardiac prevention, enhancing patient well-being and reducing the burden on the health system.
Abstract:
The effects of an outhospital cardiac rehabilitation program in "heart groups" (HG) are studied in a case-control design. The control group (KG) was collected by match-pairing from 12,560 cases of a rehabilitation clinic fitting in the relevant criteria to those of members of the HG. Patients of both groups (n = 75/group) after myocardial infarction and CABG were followed up over 7.5 years. There was no significant difference in risk factor modification. Exercise tolerance improved significantly in the HG by increasing maximum work capacity by 50% in spite of a mean age of 60 years at the beginning. Members of HG had significantly lesser cardiac complaints and lower need for cardiac medication. Cardiac morbidity was reduced by 54% and costs for medical care were lowered by 47% in HG. Although effects of secondary prevention on reducing risk factors were still insufficient, exercise tolerance in higher age and quality of life were improved, reduction in medication and in the morbidity saved costs for the health system.
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