Article

Heart failure is a common and costly condition, particularly in the
elderly. A range of models of interventions have shown the capacity to decrease
hospitalizations and improve health-related outcomes. Potentially, cardiac
rehabilitation models can also improve outcomes. AIM: To assess the impact of a
nurse-coordinated multidisciplinary, cardiac rehabilitation program to decrease
hospitalizations, increase functional capacity, and meet the needs of patients
with heart failure. METHOD: In a randomized control trial, a total of 105
patients were recruited to the study. Patients in the intervention group received
an individualized, multidisciplinary 12-week cardiac rehabilitation program,
including an individualized exercise component tailored to functional ability and
social circumstances. The control group received an information session provided
by the cardiac rehabilitation coordinator and then follow-up care by either their
cardiologist or general practitioner. This trial was stopped prematurely after
the release of state-based guidelines and funding for heart failure programs.
RESULTS: During the study period, patients in the intervention group were less
likely to have been admitted to hospital for any cause (44 vs. 69%, P = 0.01) or
after a major acute coronary event (24 vs. 55%, P = 0.001). Participants in the
intervention group were more likely to be alive at 12 months, (93 vs. 79%; P =
0.03) (odds ratio = 3.85; 95% confidence interval=1.03-14.42; P = 0.0042).
Quality of life scores improved at 3 months compared with baseline (intervention
t = o/-4.37, P<0.0001; control t = /-3.52, P<0.01). Improvement was also seen in
6-min walk times at 3 months compared with baseline in the intervention group (t
= 3.40; P = 0.01). CONCLUSION: This study shows that a multidisciplinary heart
failure cardiac rehabilitation program, including an individualized exercise
component, coordinated by a specialist heart failure nurse can substantially
reduce both all-cause and cardiovascular readmission rates, improve functional
status at 3 months and exercise tolerance.

Langue : ANGLAIS

Tiré à part : OUI