Improving the Quality of Care Following an Acute Cardiac Event—The Role of Cardiac Rehabilitation in the Care Continuum

2009 ◽  
Vol 6 (2) ◽  
pp. 79-83
Author(s):  
Marjorie L King ◽  

2011 ◽  
Vol 10 (1_suppl) ◽  
pp. 37-37
Author(s):  
P.H. Delrez ◽  
J. Dutrannois ◽  
O. Van Caenegem ◽  
C.H. Brohet ◽  
J.-M. Riou

2011 ◽  
Vol 10 ◽  
pp. S37
Author(s):  
P.H. Delrez ◽  
J. Dutrannois ◽  
O. Van Caenegem ◽  
C.H. Brohet ◽  
J.-M. Riou

2002 ◽  
Vol 39 ◽  
pp. 452-453
Author(s):  
Edward P. Havranek ◽  
Pam Wolfe ◽  
Frederick A. Masoudi ◽  
Harlan M. Krumholz ◽  
Saif S. Rathore ◽  
...  

2021 ◽  
Vol 16 (8) ◽  
pp. 1-9
Author(s):  
Hazel Nikolov ◽  
Julia Hubbard

Cardiac rehabilitation improves the outcomes of individuals following a cardiac event; however, only 50% of those eligible for cardiac rehabilitation in the UK sign up to a traditional face-to-face programme. The principal causes cited for non-attendance include living in a rural area, work or career commitments, lack of choice in location, gender, ethnicity and social economic constraints, and dislike of group participation. Alternative methods of delivery could ensure greater participation in cardiac rehabilitation activities, particularly among women, who are underrepresented. Studies into digital cardiac rehabilitation reveal improved quality of life, dietary intake and increased physical activity all equal to or an improvement compared to traditional approaches. Embracing digital approaches to cardiac rehabilitation is now timely with COVID-19 requirements for social distancing.


2021 ◽  
Vol 14 (3) ◽  
pp. 215-221
Author(s):  
Maciej Janiszewski ◽  
Artur Mamcarz

The role of comprehensive cardiac rehabilitation (CCR) is well established in the secondary prevention of cardiovascular diseases such as coronary artery disease and heart failure. Many clinical trials demonstrated effectiveness of CCR in improving exercise capacity, quality of life, and in reducing cardiovascular mortality and morbidity. However, even before the era of the COVID-19 pandemic comprehensive cardiac rehabilitation program’s implementation, especially the second phase, had many barriers. One of the main reasons for not attending in second phase of CCR was lack of transportation from patient’s home to rehabilitation centers. Additionally, in recent months COVID-19 pandemic has led to closure of many cardiac rehabilitation centres resulting in many eligible patients unable to participate in the optimisation of secondary prevention. During the coronavirus disease-2019 pandemic, hybrid telerehabilitation has become the leading solution in the cardiac rehabilitation programs. The present paper contains key information about structures, effectives and safety of hybrid telerehabilitation during the COVID-19 era.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Hudzik ◽  
A Budaj ◽  
M Gierlotka ◽  
A Witkowski ◽  
W Wojakowski ◽  
...  

Abstract Introduction 2017 ESC Guidelines for the management of ST-elevation myocardial infarction (STEMI) patients have called for the assessment of the quality of care to establish measurable quality indicators in order to ensure that every patient with STEMI receives the best possible care. We investigated the quality indicators of health care services in Poland provided to STEMI patients. Methods The Polish Registry of Acute Coronary Syndromes (PL-ACS) is an ongoing, nationwide, multicenter, prospective, observational study of consecutively hospitalized patients with the whole spectrum of ACS in Poland. For the purpose of assessing quality indicators, we included 8,279 patients from the PL-ACS Registry hospitalized with STEMI between January 1 and December 31, 2018. Results All emergency medical services (EMS) are equipped with ECG/defibrillators. 408 of 8,279 patients (4.9%) arrived at PCI center by self-transport, 4,791 patients (57.9%) patients arrived at PCI center by direct EMS transport, and 2,900 patients (37.2%) were transferred from non-PCI facilities. Whilst 95.1% of STEMI patients arriving in the first 12 hours received reperfusion therapy, the rates of timely reperfusion were much lower (ranging from 39.4% to 55.0% for various STEMI pathways). 7,807 patients (94.3%) underwent PCI as a mode of primary reperfusion strategy. The median left ventricular ejection fraction (LVEF) was 46% and was assessed before discharge in 86.0% of patients. 489 of 8,279 patients (5.9%) died during hospital stay. Optimal medical therapy is prescribed in 50–85% of patients depending on various clinical settings. Only one in two STEMI patient is enrolled in a cardiac rehabilitation program at discharge. No patient-reported outcomes were recorded in the PL-ACS Registry. Figure 1 Conclusions The results of this study identified areas of healthcare systems that require solid improvement. These include prehospital ECG decision strategy, direct transport to PCI center, timely reperfusion, guidelines-based medical therapy (in particular in patients with heart failure), referral to cardiac rehabilitation/secondary prevention programs. More importantly, we recognized an urgent need for the initiation of recording quality indicators associated with patient-reported outcomes.


Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Heidi D. Klepin

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.


2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 376-376
Author(s):  
Rachel M Lee ◽  
Danielle K DePalo ◽  
Alexandra G Lopez-Aguiar ◽  
Mohammad Yahya Zaidi ◽  
Flavio G. Rocha ◽  
...  

376 Background: The prognostic value of pathologic variables is not consistent for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We previously demonstrated a limited prognostic role of lymph node (LN) positivity in small bowel NETs (SBNET) compared to pancreatic NETs (panNET). Although minority race is often associated with worse cancer outcomes, the interaction of race with pathologic and oncologic outcomes of pts with GEP-NETS is not known. Methods: Pts with GEP-NETs who underwent curative intent resection at eight institutions of the US NET Study Group from 2000-16 were included. Given few pts of other races, only Black and White race pts were analyzed. Results: Of 2,182 pts, 1,143 met inclusion criteria. Median age was 58 yrs, median follow up was 3 yrs, 48% were male, 14% (n = 157) were Black, and 86% (n = 986) were White. Black pts were more likely uninsured (7 vs 2%, p = 0.005), had symptomatic bleeding (13 vs 7%, p = 0.006), required emergency surgery (7 vs 3%, p = 0.003), and had LN positive disease (47 vs 36%, p = 0.016). Despite this, Black pts had improved 5 yr recurrence free survival (RFS) compared to White pts (90 vs 80%, p = 0.008). The quality of care received was comparable between both groups, demonstrated by similar LN yield at surgery, neg margin resection rate, post-op complications, and need for reoperation or readmission (all p > 0.05). Black pts were more likely to have SBNET (22 vs 13%) and less likely to have panNET (43 vs 68%) compared to White pts (p < 0.001). Consistent with prior data, pts with LN pos panNET had decreased 5yr RFS (67 vs 83%, p = 0.001); however, for SBNET, LN involvement was not prognostic (77 vs 96%, p = 0.08). The prognostic value of LN pos disease was similar between Black and White pts in both SBNET (p = 0.34) and panNET (p = 0.95). Conclusions: Black pts with GEP-NET present with more advanced disease, including higher LN positivity. Despite this, Black pts have improved RFS compared to White pts. Although there may be delays in seeking or reaching care, Black pts received similar quality of care compared to White pts. The improved RFS seen in Black pts may be attributed to the epidemiologic differences in the site of presentation of GEP-NETs and variable prognostic value of LN pos disease.


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