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Eike Langheim1, Christoph Schmitz2,3, Volker Köllner3,4
1Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund Abteilung Kardiologie.
Insights
Psychological conditions significantly impact heart disease recovery, necessitating integrated care. Interdisciplinary psychocardiological rehabilitation effectively addresses these comorbidities, improving patient activity and participation.
Area of Science:
- Cardiology
- Psychiatry
- Rehabilitation Medicine
Background:
- Psychological comorbidities like depression and anxiety significantly influence heart disease progression and recovery.
- The interplay between cardiac and mental health disorders necessitates specialized, integrated treatment approaches.
- Current monodisciplinary rehabilitation often fails to adequately address the complex needs of patients with comorbid conditions.
Purpose of the Study:
- To describe the development and implementation of an interdisciplinary psychocardiological rehabilitation concept.
- To evaluate the effectiveness of this concept in patients with comorbid psychological and somatic conditions.
- To present findings from the EvaPK study on psychocardiological rehabilitation's impact on activity and participation.
Main Methods:
- Development and implementation of an interdisciplinary psychocardiological rehabilitation program.
- Pilot study evaluation of the concept's acceptance and initial outcomes.
- Controlled EvaPK study to assess effectiveness using measures like the Mini-ICF-APP-S.
Main Results:
- The interdisciplinary concept demonstrated positive initial evaluation data and good acceptance by patients.
- The EvaPK study indicated that psychocardiological rehabilitation is effective for highly stressed comorbid patients, particularly in improving activity and participation.
- Patients with psychological comorbidities experience significant stress impacting their activity and participation.
Conclusions:
- Interdisciplinary psychocardiological rehabilitation effectively meets the needs of comorbid patients.
- The presented concept requires higher personnel costs and intensive interdisciplinary cooperation for successful implementation.
- Further research is needed to evaluate long-term outcomes, including catamnesis and cardiac function parameters.
Abstract:
The development and course of heart disease can be decisively influenced by psychological comorbidities (especially depression, anxiety disorder or post-traumatic stress disorder). An acute or chronic cardiological disease can in turn trigger or exacerbate mental disorders. These relationships are of considerable importance for cardiac rehabilitation, since psychological comorbidities often limit activity and participation more than organic heart disease. In monodisciplinary rehabilitation procedures (cardiological or psychosomatic), however, in the case of comorbidity, one clinical picture cannot be adequately treated and assessed by socio-medical experts. Interdisciplinary rehabilitation concepts are required here.In the first part of this article, the development and implementation of an interdisciplinary psychocardiological rehabilitation concept from the model phase to the establishment and expansion to other disciplines as well as the first research results are described. After initial positive evaluation data and good acceptance by the rehabilitants, the German Pension Insurance (DRV) is expanding the concept to other specialist areas under the name "dual rehabilitation" in order to promote interdisciplinary cooperation in the case of psychological and somatic comorbidity.In the second part of the work, the concept and first data from the controlled EvaPK study (Evaluation of the effectiveness of psychocardiological rehabilitation) funded by the DRV Bund are presented. These show that the comorbid patients are particularly stressed in terms of activity and participation (recorded in the Mini-ICF-APP-S) and that psychocardiological rehabilitation is also effective in this highly stressed group. However, the evaluations of the catamnesis and the cardiac function parameters are still missing.Both the pilot study and the first data from the EvaPK study show that psychocardiological rehabilitation meets the needs of comorbid patients and is well accepted by them. However, successful psychocardiological rehabilitation according to the concept presented here requires higher personnel costs and intensive, equal cooperation. Further research on this is necessary.