Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs

The review discusses the participation of patients with coronary artery disease after acute myocardial infarction and revascularization surgeries in cardiac rehabilitation (CR) and secondary prevention programs. The problems of patients not being included in rehabilitation programs and the reasons for low adherence to these programs are considered. The contribution of non-drug therapy to achievement of CR and secondary prevention goals is discussed. Various strategies are proposed for involving and increasing adherence of patients to CR programs.

Association between a national public health campaign for physical activity for patients with chronic diseases and the participation in Phase III cardiac rehabilitation in Luxembourg

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National public health campaign may increase participation to Phase III cardiac rehabilitation.

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National public health campaign increases visibility of a website displaying the Phase III cardiac rehabilitation.

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A more integrated and synergized strategic approach may help to sensitize the patients.

Background

A 2-stage national campaign promoting physical activity for patients with chronic diseases (including cardiovascular disease) was implemented in the Grand-Duchy of Luxembourg in 2018. The first stage consisted of national TV and radio advertisements broadcasted from June 15, 2018 to July 29, 2018. The second stage was a promotional mail sent to all medical doctors on September 3, 2018. This study investigated the association between this campaign and the participation of cardiac patients in Phase III cardiac rehabilitation as well as the visibility of a dedicated website (www.sport-sante.lu).

Methods

The daily numbers of participants in the classes of the Phase III cardiac rehabilitation and the visits on www.sport-sante.lu were collected from January 1, 2016 to December 31, 2018. Segmented regression analysis was used to assess the association between the promotional campaign and the participation in the Phase III cardiac rehabilitation as well as the website visibility.

Results

The baseline participation rate, which was 30 participants/day, increased temporarily by 11 (p = 0.0267) and 18 (p = 0.0030) participants/day after the first and second stages of the campaign, respectively. The baseline visit rate on www.sport-sante.lu, which was 12 visits/day, increased temporarily by 20 (p < 0.0001) and 15 (p = 0.0002) visits/day after the first and second stages of the campaign, respectively.

Conclusions

The national public health campaign was associated with a limited increased participation in the Phase III cardiac rehabilitation and the website visibility. However, no conclusion can be drawn about causality due to the long and difficult process from health promotion to patient’s behavior change.

Physical activity for patients with heart failure: Position paper from the heart failure (GICC) and cardiac rehabilitation (GERS-P) Working Groups of the French Society of Cardiology

Physical activity is important in heart failure to improve functional capacity, quality of life and prognosis, and is a class IA recommendation in the European Society of Cardiology guidelines (Ponikowski et al., 2016). The benefits of exercise training are widely recognized. Cardiac rehabilitation centres offer tailored exercise training to patients with heart failure, as part of specialized multidisciplinary care, alongside pharmacological treatment optimization and patient education. After cardiac rehabilitation, maintenance of regular physical activity long term is essential, as the benefits of exercise training vanish within a few weeks. Unfortunately, only 10% of patients benefit from a cardiac rehabilitation programme after hospitalization for acute heart failure, and the majority of patients do not pursue long-term physical activity. In this paper, two Working Groups of the French Society of Cardiology (the heart failure group [Groupe Insuffisance Cardiaque et Cardiomyopathies; GICC] and the cardiac rehabilitation group [Groupe Exercice Réadaptation Sport et Prévention; GERS-P]) discuss the obstacles to broader access to cardiac rehabilitation centres, and propose ways to improve the diffusion of cardiac rehabilitation programmes and encourage long-term adherence to physical activity.