title: [Effect of optimized integrated management on long-term effectiveness of cardiologic rehabilitation].
abstract: OBJECTIVE
  Long-term risk factor (RF) modification after cardiac rehabilitation (CR) is less than satisfactory. Problems of communication between the CR centre and the practising physician (GP) are one potential source of sub-optimal management. The goal of the PROTECT-study was to evaluate the influence of improved communication between rehabilitation centres and the GP on the quality of RF-modification.
  
  
  METHODS
  In 50 specialized CR centres 882 patients in the group with intensified communication were compared to 160 patients in the usual care group. All patients underwent a course of residential CR. Intensified communication was attempted by a total of four phone calls to the GP, a RF booklet in which the RF profile, the individual RF treatment goals and the current RF status were delineated. Main treatment goals with respect to RF-modification after 6 months were: Blood pressure < 140/90 mmHg, LDL-Cholesterol < 100 mg/dl or at least 115 mg/dl and a body mass index of < 25 or at least < 30.
  
  
  RESULTS
  The percentage of of patients with adequate blood pressure control (< 140/90 mmHg) was 85.1% vs. 85%, with LDL-cholesterol < 100 mg/dl 27.2% vs. 23.9%, with good body-mass index (< 25) 32.4% vs. 28.2% (intensified communication vs. control group; p = ns). The treatment initiated by the CR centres was continued in about 90% of patients.
  
  
  CONCLUSIONS
  The study has shown that improved communication between the CR centres and the GP's after CR had only a marginal effect on the quality of RF-management. One key element of secondary prevention could be to get the patient more strongly involved in reaching the targets of therapy.
authors.affiliation: Klinische Kardiologie II, Herz-Zentrum Bad Krozingen.
authors.forename: H
authors.initials: H
authors.lastname: Gohlke
authors.forename: H
authors.initials: H
authors.lastname: Jarmatz
authors.forename: J
authors.initials: J
authors.lastname: Zaumseil
authors.forename: K
authors.initials: K
authors.lastname: Bestehorn
authors.forename: C
authors.initials: C
authors.lastname: Jansen
authors.forename: J
authors.initials: J
authors.lastname: Hasford
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000534:rehabilitation; D003142:Communication; D001026:Coronary Artery Bypass / Q000534:rehabilitation; D003327:Coronary Disease / Q000534:rehabilitation*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D010348:Patient Care Team; D011320:Primary Health Care; D012047:Rehabilitation Centers; D012307:Risk Factors