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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Usefulness of Inter-Hospital Heart Team Conference Based Collaborative Outpatient Cardiac Rehabilitation in Patients
Yuta Kobayashi1, Takanori Arimoto1, Daisuke Kutsuzawa1
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine.
Insights
Inter-hospital heart team conferences enhance collaborative cardiac rehabilitation (CR) follow-up for cardiovascular disease patients. This approach proved as safe and effective as traditional methods, improving patient outcomes.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Health Services Research
Background:
- Outpatient cardiac rehabilitation (CR) programs are crucial for cardiovascular disease (CVD) patients.
- Hospitals lacking dedicated CR centers face challenges in providing comprehensive follow-up care.
- Inter-hospital collaboration may offer a solution for extending CR accessibility.
Purpose of the Study:
- To evaluate the efficacy and safety of inter-hospital heart team conference-based collaborative follow-up (FU) for outpatient CR.
- To compare collaborative FU with same-hospital FU in patients with cardiovascular disease.
- To assess the impact of collaborative FU on patient prognosis and clinical parameters.
Main Methods:
- A prospective study involving 145 cardiovascular disease patients divided into collaborative FU (n=76) and same-hospital FU (n=69) groups.
- Collaborative FU involved monthly inter-hospital heart team conferences with CR specialists.
- Clinical outcomes, including peak oxygen uptake (VO2), anaerobic threshold, brain natriuretic peptide, and left ventricular ejection fraction, were measured.
- Kaplan-Meier analysis was used to compare prognosis between groups.
Main Results:
- No cardiovascular accidents occurred in either group during outpatient CR.
- Significant improvements in peak oxygen uptake (VO2), anaerobic threshold, brain natriuretic peptide, and left ventricular ejection fraction were observed in both groups.
- Kaplan-Meier analysis showed no significant difference in prognosis between the collaborative and same-hospital FU groups (P=0.246).
- Inter-hospital heart team conferences facilitated discussions on continuing CR programs for 38.2% of patients in the collaborative group.
Conclusions:
- Inter-hospital heart team conference-based collaborative FU is a safe and effective strategy for outpatient CR.
- This collaborative model demonstrates comparable efficacy and prognostic outcomes to same-hospital FU.
- Regular inter-hospital heart team conferences are valuable for enhancing collaboration and accessibility in outpatient CR programs.
Abstract:
An inter-hospital heart team conference based collaborative follow-up (FU) may facilitate outpatient cardiac rehabilitation (CR) programs, especially in hospitals without an outpatient CR center. Consecutive 145 patients with cardiovascular disease who received inpatient treatment at Yamagata University Hospital were divided into collaborative (n = 76) and same-hospital (n = 69) FU groups. In the collaborative FU group, patients received outpatient care at a university hospital and outpatient CR at different hospitals. In the same-hospital FU group, patients received outpatient care and outpatient CR at the same hospital other than the university hospital. The collaborative FU group held monthly 60-minute inter-hospital heart team conferences with CR specialists. No cardiovascular accidents occurred during the outpatient CR program in either group. Peak oxygen uptake VO2, anaerobic threshold, brain natriuretic peptide level, and left ventricular ejection fraction significantly improved in both groups. Kaplan-Meier analysis revealed no significant difference in prognosis between the collaborative and same-hospital FU groups (P = 0.246). Of the patients who had collaborative CR programs, 29 (38.2%) patients (37 consultations) were discussed at an inter-hospital heart team conference. Eighteen (48.6%) consultations were for issues related to continuing outpatient CR programs. Collaborative FU was as useful as same-hospital FU in terms of safety, efficacy, and prognosis in patients with cardiovascular disease. We conclude that regular inter-hospital heart team conferences are useful for facilitating collaboration among outpatient CR programs.
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