|
Investigators:
Dr Marian Worcester, Dr Alan Goble,
Dr Barbara Murphy, Dr Peter Elliott, Heart Research Centre; Dr Jeremy Pereira,
Dr Robert Newman, Western Hospital;
Professor James Tatoulis, Cardiothoracic Surgical Unit and Dr Leeanne Grigg, Cardiology Department, The Royal Melbourne Hospital.
Background
Previous research has shown that CRP
attendance is associated with improved outcomes including lower mortality,
lower morbidity rates and better quality of life among patients who have
experienced acute cardiac events. The evidence for these claims for secondary
prevention has been reported in a few studies, from meta-analyses and is
summarised in the Heart Research Centre's Best Practice Guidelines for Cardiac
Rehabilitation and Secondary Prevention. The reduction in mortality is largely
demonstrated in randomised controlled trials conducted in Finland, the United
Kingdom and other European countries during the 1970s and 1980s. Most of the
evidence to support these endorsements comes from studies in patients who have
had MI. Pooled data from numerous randomised trials of CR after MI have
documented a 20% to 25% reduction in all-cause and cardiovascular mortality over
three years. It may be that the benefits arise not only from the exercise
component of these programs, but from the comprehensive nature of the interventions
which also include risk factor modification, education and counselling.
The present study involves a follow-up of 573
(88%) of 652 patients consecutively admitted to three Melbourne hospitals for a
study of attendance patterns at CRPs conducted in 1996-1997. Of the 652
eligible patients, 573 were tracked four months after their acute event to
determine whether or not they had attended and completed a CRP. There were 79
patients who could not be located. Thus,
there was an 88% follow-up rate among known survivors in the study. Of these patients, 284 (49.6%) had attended a
CRP, while 272 (47.5%) had not. Amongst attenders, 67 (23.6%) patients
discontinued the program. All patients interviewed at baseline consented to
participate in a follow-up study.
|
