Effect of an Educational Intervention on Cardiac Patients' Participation Rate in Cardiac Rehabilitation Programs

NCT ID: NCT00356863

Last Updated: 2017-11-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1024 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-02-29

Study Completion Date

2009-12-31

Brief Summary

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The main aim of the study is to determine the effectiveness of an educational intervention designed to increase attendance of coronary artery bypass grafting (CABG) patients at Cardiac Rehabilitation Programs (CRPs) on actual CRP participation rate and; examine patient-related factors (demographic, health, psychosocial, awareness) influencing patients' attendance at CRPs. We hypothesized that the proportion of CABG patients participating in CRPs will increase significantly to 20-30% following the educational intervention employed.

Detailed Description

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Coronary heart disease (CHD) is a major cause of disability and economic burden in western societies. Ample evidence exists to suggest that participation of these patients in structured Cardiac Rehabilitation Programs (CRPs) is beneficial in terms of improved prognosis and quality of life. Despite inclusion of cardiac rehabilitation (CR) in the Medical Insurance Basket (MIB) as a treatment for patients after an acute myocardial infarction (MI), for those after coronary artery bypass grafting (CABG), and more recently for patients suffering from congestive heart failure, only a small proportion (5%-7.5%) of patients take part in CRPs in Israel. Several factors have been identified as barriers to CRP in Israel, two of which are lack of patients motivation to participate in CRPs stemming, in part, from lack of awareness regarding the importance of CR and its availability and; Lack of motivation of medical staff to refer patients to CR resulting from a unawareness of the importance of CR and its availability across Israel, to name a few. The present study accords with such recommendations, by proposing a simple intervention designed to improve patients' and medical staff's awareness to the importance of CR participation. It is expected that CRP participation will significantly increase to 20-30% following the educational intervention employed.

This intervention will provide the basis for the implementation of an intervention to increase CRP participation in cardiac patients at a national level.

In addition to increasing the proportion of CABG patients attending at CRPs, the study aims to measure the effect of CRP participation on subsequent 1-year health and behavior related outcomes, and 3-year mortality. We expect to find differences in outcome measures between participating patients and those who do not.

Conditions

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Coronary Artery Disease

Keywords

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Intervention Awareness Cardiac Rehabilitation (CR) Coronary Artery Patients Coronary Artery Bypass Grafting Surgery (CABG)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Explanation on cardiac rehabilitation

Intervention: Increasing awareness to cardiac rehabilitation programs: Patients received a written and oral short explanation on the importance and benefits of cardiac rehabilitation (CR) participation, and information on available programs. They were telephoned 2 weeks after hospital discharge to encourage them to enroll at a cardiac rehabilitation program (CRP). In addition, physicians and nurses at the cardiothoracic units participated in a 1-hour seminar on CR. A recommendation to the general physician to refer the patient to CRP was added to the letter of discharge from hospital.

Group Type EXPERIMENTAL

Increasing awareness to cardiac rehabilitation programs

Intervention Type BEHAVIORAL

Increasing awareness to cardiac rehabilitation programs: Before coronary artery bypass grafting (CABG) surgery patients received a face-to-face explanation on their right to participate in cardiac rehabilitation programs (CRPs) under the Israeli Basket of Health Services; they were also provided with a brochure on the benefits of CRP participation and the availability of CRPs throughout the country.

Usual care with no intervention

Patients recruited to the study received the usual care without any additional explanation on cardiac rehabilitation, and no effort to increase their awareness or the ward's awareness to cardiac rehabilitation was done.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Increasing awareness to cardiac rehabilitation programs

Increasing awareness to cardiac rehabilitation programs: Before coronary artery bypass grafting (CABG) surgery patients received a face-to-face explanation on their right to participate in cardiac rehabilitation programs (CRPs) under the Israeli Basket of Health Services; they were also provided with a brochure on the benefits of CRP participation and the availability of CRPs throughout the country.

Intervention Type BEHAVIORAL

Other Intervention Names

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Improving participation at cardiac rehabilitation programs

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing Coronary Artery Bypass Grafting with or without valve replacement

Exclusion Criteria

* Institutionalized patients
* Patients with severe co-morbidities for whom cardiac rehabilitation (CR) is contra-indicated
* Patients who sustained a severe surgical complication preventing them from participating in CR (general stroke with severe disability)
* Patients residing farther than 30 km from a rehabilitation center
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Gertner Institute

OTHER

Sponsor Role collaborator

Israel National Institute for Health Policy and Health Services Research

OTHER_GOV

Sponsor Role collaborator

Sheba Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Dr. Rachel Dankner

Senior investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rachel Dankner, MD MPH

Role: PRINCIPAL_INVESTIGATOR

The Gertner Institute for Epidemiology and Health Service Research, Sheba Medical Center

Locations

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Sheba Medical Center, the Gertner institute for epidemiology and health service research

Ramat Gan, , Israel

Site Status

Countries

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Israel

References

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Dankner R, Drory Y, Geulayov G, Ziv A, Novikov I, Zlotnick AY, Moshkovitz Y, Elami A, Schwammenthal E, Goldbourt U. A controlled intervention to increase participation in cardiac rehabilitation. Eur J Prev Cardiol. 2015 Sep;22(9):1121-8. doi: 10.1177/2047487314548815. Epub 2014 Sep 2.

Reference Type BACKGROUND
PMID: 25183694 (View on PubMed)

Gendler Y, Geulayov G, Ziv A, Novikov I, Dankner R; Multi-Center Cardiac Rehabilitation Israeli Working Group. [A multicenter intervention study on referral to cardiac rehabilitation after coronary artery bypass graft surgery: a 1-year follow-up of rehabilitation rates among USSR-born and veteran Israeli patients]. Harefuah. 2012 Sep;151(9):511-7, 558, 557. Hebrew.

Reference Type RESULT
PMID: 23367742 (View on PubMed)

Dankner R, Geulayov G, Ziv A, Novikov I, Goldbourt U, Drory Y. The effect of an educational intervention on coronary artery bypass graft surgery patients' participation rate in cardiac rehabilitation programs: a controlled health care trial. BMC Cardiovasc Disord. 2011 Oct 8;11:60. doi: 10.1186/1471-2261-11-60.

Reference Type RESULT
PMID: 21982052 (View on PubMed)

Moshkovitz Y, Orenstein L, Olmer L, Laufer K, Ziv A, Dankner R. Emulated Trial for Discharge Prescription of Guideline-Directed Medical Therapy and 15-Year Survival After Coronary Artery Bypass Graft Surgery. Mayo Clin Proc. 2024 May;99(5):766-779. doi: 10.1016/j.mayocp.2023.06.022. Epub 2024 Mar 7.

Reference Type DERIVED
PMID: 38456874 (View on PubMed)

Geulayov G, Novikov I, Dankner D, Dankner R. Symptoms of depression and anxiety and 11-year all-cause mortality in men and women undergoing coronary artery bypass graft (CABG) surgery. J Psychosom Res. 2018 Feb;105:106-114. doi: 10.1016/j.jpsychores.2017.11.017. Epub 2017 Dec 1.

Reference Type DERIVED
PMID: 29332626 (View on PubMed)

Related Links

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http://bjll.org/index.php/ejpch/article/view/684

THE PSYCHOMETRIC PROPERTIES OF THE RUSSIAN VERSION OF THE MACNEW HEART DISEASE HEALTH-RELATED QUALITY OF LIFE SCALE IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING SURGERY

https://www.omicsonline.org/validation-of-the-hebrew-version-of-the-macnew-heart-disease-healthrelated-quality-of-life-questionnaire-in-patients-undergoing-coronary-artery-bypass-surgery-2155-9880.1000279.php?aid=21660

Validation of the Hebrew Version of the MacNew Heart Disease Healthrelated Quality of Life Questionnaire in Patients Undergoing Coronary Artery Bypass Surgery

Other Identifiers

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SHEBA-05-2374-RD-CTIL

Identifier Type: -

Identifier Source: org_study_id