Werner Benzer1, Bernhard Rauch2, Jean-Paul Schmid3, Ann Dorthe Zwisler4, Paul Dendale5, Constantinos H Davos6, Evangelia Kouidi7, Attila Simon8, Ana Abreu9, Nana Pogosova10, Dan Gaita11, Bojan Miletic12, Gerd Bönner13, Taoufik Ouarrak2, Hannah McGee14. 1. Reha Sports Institute and Case Management Centre, Feldkirch, Austria. Electronic address: wbenzer@cable.vol.at. 2. Institut für Herzinfarktforschung, Ludwigshafen, Germany. 3. Department of Cardiology, Spital Tiefenau, Bern, Switzerland. 4. National Center of Rehabilitation and Palliation, University of Southern Denmark and University Hospital Odense, Denmark. 5. Hasselt University and Hartcentrum Hasselt, Belgium. 6. CV Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece. 7. Sports Medicine Laboratory, Aristotle University of Thessaloniki, Thessaloniki, Greece. 8. State Hospital for Cardiology, Balatonfured, Hungary. 9. Serviço de Cardiologia, Hospital Santa Marta, Lisbon, Portugal. 10. Federal Health Center and National Center for Preventive Medicine, Moscow, Russia. 11. Cardiac Rehabilitation Clinic, University of Medicine and Pharmacy, Timisoara, Romania. 12. Clinic for Diagnostic, Rehabilitation and Prevention of CV Diseases, Thalassotherapia Opatija, Croatia. 13. Park Klinikum Lazariterhof, Bad Krozingen, Germany. 14. Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland.
Abstract
AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR differed between countries being predominantly ACS in Switzerland (79%), Portugal (62%) and Germany (61%), elective PCI in Greece (37%), Austria (36%) and Spain (32%), and CABG in Croatia and Russia (36%). A minority of patients presented with chronic heart failure (4%). At CR start, most patients already were under medication according to current guidelines for the treatment of CV risk factors. A wide range of CR programme designs was found (duration 3 to 24weeks; total number of sessions 30 to 196). Patient programme adherence after admission was high (85%). With reservations that eCRF follow-up data exchange remained incomplete, patient CV risk profiles experienced only small improvements. CR success as defined by an increase of exercise capacity >25W was significantly higher in young patients and those who were employed. Results differed by countries. After CR only 9% of patients were admitted to a structured post-CR programme. CONCLUSIONS: Clinical characteristics of CR patients, indications and programmes in Europe are different. Guideline adherence is poor. Thus, patient selection and CR programme designs should become more evidence-based. Routine eCRF documentation of CR results throughout European countries was not sufficient in its first application because of incomplete data exchange. Therefore better adherence of CR centres to minimal routine clinical standards is requested.
AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR differed between countries being predominantly ACS in Switzerland (79%), Portugal (62%) and Germany (61%), elective PCI in Greece (37%), Austria (36%) and Spain (32%), and CABG in Croatia and Russia (36%). A minority of patients presented with chronic heart failure (4%). At CR start, most patients already were under medication according to current guidelines for the treatment of CV risk factors. A wide range of CR programme designs was found (duration 3 to 24weeks; total number of sessions 30 to 196). Patient programme adherence after admission was high (85%). With reservations that eCRF follow-up data exchange remained incomplete, patient CV risk profiles experienced only small improvements. CR success as defined by an increase of exercise capacity >25W was significantly higher in young patients and those who were employed. Results differed by countries. After CR only 9% of patients were admitted to a structured post-CR programme. CONCLUSIONS: Clinical characteristics of CR patients, indications and programmes in Europe are different. Guideline adherence is poor. Thus, patient selection and CR programme designs should become more evidence-based. Routine eCRF documentation of CR results throughout European countries was not sufficient in its first application because of incomplete data exchange. Therefore better adherence of CR centres to minimal routine clinical standards is requested.
Authors: Amanda L Hannan; Wayne Hing; Mike Climstein; Jeff S Coombes; James Furness; Rohan Jayasinghe; Joshua Byrnes Journal: Open Access J Sports Med Date: 2018-04-30
Authors: Matthias Lutz; David Messika-Zeitoun; Tanja K Rudolph; Eberhard Schulz; Jeetendra Thambyrajah; Guy Lloyd; Alexander Lauten; Norbert Frey; Jana Kurucova; Martin Thoenes; Cornelia Deutsch; Peter Bramlage; Richard Paul Steeds Journal: Open Heart Date: 2020-09