Short-term patient-reported outcomes after different exercise-based cardiac rehabilitation programmes.
BACKGROUND
An objective of exercise-based cardiac rehabilitation is improvement in patient-reported outcomes such as health-related quality of life as well as anxiety and depressive symptoms. There are no direct comparisons of the effectiveness of inpatient and outpatient exercise-based cardiac rehabilitation programmes on patient-reported outcomes.


METHODS
In this non-randomized study we collected patient-reported outcomes data with the MacNew Heart Disease health-related quality of life questionnaire and the Hospital Anxiety and Depression Scale at baseline, 1 month and again 3 months after admission to exercise-based cardiac rehabilitation in a cohort of 216 consecutive patients enrolled either in a 4-week inpatient exercise-based cardiac rehabilitation (n=62) or a 3-month outpatient exercise-based cardiac rehabilitation (n=87) and in a usual care group (n=67) to document the natural course in patient-reported outcome variables without exercise-based cardiac rehabilitation.


RESULTS
Although MacNew health-related quality of life scores improved more with inpatient than outpatient exercise-based cardiac rehabilitation by month 1, the improvement was still significant in both groups at month 3 and also in the usual care group when compared to baseline. The health-related quality of life scores in the inpatient group, however, decreased between month 1 and 3 whereas they continued to improve in the outpatient group. The significant reduction in both anxiety and depressive symptoms in both exercise-based cardiac rehabilitation groups by month 1 was maintained at month 3 only with outpatient exercise-based cardiac rehabilitation. No significant changes over the 3 months were observed in the usual care group.


CONCLUSIONS
Significant improvements of 1-month patient-reported outcomes are achieved in patients attending inpatient as well as outpatient exercise-based cardiac rehabilitation when compared with no exercise-based cardiac rehabilitation. In contrast to inpatient exercise-based cardiac rehabilitation, however, outpatient exercise-based cardiac rehabilitation leads to a further improvement of patient-reported outcomes. These results suggest that, if patients have to be admitted for inpatient exercise-based cardiac rehabilitation, this programme should be followed by an outpatient exercise-based cardiac rehabilitation to further improve and stabilize these patient-reported outcome variables.
Benzer
Werner
W
Department of Interventional Cardiology, Academic Hospital, Austria. wbenzer@cable.vol.at
Platter
Marion
M
Oldridge
Neil B
NB
Schwann
Helmut
H
Machreich
Kurt
K
Kullich
Werner
W
Mayr
Karl
K
Philippi
Axel
A
Gassner
Alfred
A
Dörler
Jakob
J
Höfer
Stefan
S
D000368:Aged; D000553:Ambulatory Care; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control*; D001317:Austria; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012047:Rehabilitation Centers; D012112:Residential Facilities; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome