title: Evaluation of patient compliance, quality of life impact and cost-effectiveness of a "test in-train out" exercise-based rehabilitation program for patients with intermittent claudication.
abstract: BACKGROUND
  Patients with intermittent claudication (IC) could benefit from low-cost, effective rehabilitative programs. This retrospective study evaluates compliance, impact on Quality of Life (QoL) and cost-effectiveness of a hospital prescribed, at-home performed (Test-in/Train-out) rehabilitative program for patients with IC.
  
  
  RESULTS
  Two-hundred and eighty-nine patients with IC (71 ± 10.1 years, M = 210) were enrolled for a 2-year period. Two daily 10-min home walking sessions at maximal asymptomatic speed were prescribed, with serial check-ups at the hospital. Compliance with the program was assessed by assigning a score of 1 (lowest compliance) to 4 (highest compliance). The SF-36 questionnaire and a constant-load treadmill test were used to evaluate QoL and Initial/Absolute Claudication Distance, respectively. Both direct and indirect costs of the program were considered for cost-effectiveness analysis. Two-hundred and fifty patients (70.5 ± 9.2 years, M = 191), at Fontaine's II-B stage (86%), were included in the study. No adverse events were reported. The average compliance score was 3.1. At discharge, both SF-36 domains and walking performance significantly increased (P < 0.0001). A total of 1,839 in-hospital check-ups (7.36 /patient) were performed. Direct and indirect costs represented 93% and 7% of the total costs, respectively. The average costs of a visit and of a therapy cycle were C68.93 and C507.20, respectively. The cost to walk an additional meter before stopping was C9.22.
  
  
  CONCLUSIONS
  A Test-in/Train-out program provided favourable patient compliance, QoL impact and cost-effectiveness in patients with IC.
authors.affiliation: Vascular Diseases Center, University of Ferrara, Ferrara, Italy. mlgnmr@unife.it
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Malagoni
authors.forename: Emidia
authors.initials: E
authors.lastname: Vagnoni
authors.forename: Michele
authors.initials: M
authors.lastname: Felisatti
authors.forename: Simona
authors.initials: S
authors.lastname: Mandini
authors.forename: Mahdi
authors.initials: M
authors.lastname: Heidari
authors.forename: Francesco
authors.initials: F
authors.lastname: Mascoli
authors.forename: Nino
authors.initials: N
authors.lastname: Basaglia
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
authors.forename: Paolo
authors.initials: P
authors.lastname: Zamboni
authors.forename: Fabio
authors.initials: F
authors.lastname: Manfredini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005081:Exercise Therapy / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000191:economics* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011788:Quality of Life; D012189:Retrospective Studies