title: Cardiac rehabilitation in Austria: long term health-related quality of life outcomes.
abstract: BACKGROUND
  The goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.
  
  
  METHODS
  Patients (N = 487, 64.7% male, age 60.9 +/- 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].
  
  
  RESULTS
  All MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.
  
  
  CONCLUSIONS
  These findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.
authors.affiliation: Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria. stefan.hoefer@i-med.ac.at
authors.forename: Stefan
authors.initials: S
authors.lastname: Höfer
authors.forename: Werner
authors.initials: W
authors.lastname: Kullich
authors.forename: Ursula
authors.initials: U
authors.lastname: Graninger
authors.forename: Manfred
authors.initials: M
authors.lastname: Wonisch
authors.forename: Alfred
authors.initials: A
authors.lastname: Gassner
authors.forename: Martin
authors.initials: M
authors.lastname: Klicpera
authors.forename: Herbert
authors.initials: H
authors.lastname: Laimer
authors.forename: Christiane
authors.initials: C
authors.lastname: Marko
authors.forename: Helmut
authors.initials: H
authors.lastname: Schwann
authors.forename: Rudolf
authors.initials: R
authors.lastname: Müller
mesh_terms: D000328:Adult; D000368:Aged; D001317:Austria; D005260:Female; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D011795:Surveys and Questionnaires