Jamal Uddin1, Vicky L Joshi, Mohammad Moniruzzaman, Rezaul Karim, Jalal Uddin, Masoom Siraj, Mohammad Abdur Rashid, Henriette Knold Rossau, Rod S Taylor, Ann-Dorthe Zwisler. 1. Physiotherapy Unit, Department of Cardiac Surgery (Mr Jamal Uddin), Department of Cardiac Surgery (Drs Siraj and Jalal Uddin), and Department of Cardiology (Drs Rashid and Karim) Ibrahim Cardiac Hospital & Research Institute, Shagbag, Dhaka, Bangladesh; Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Odense University Hospital and University of Southern Denmark, Copenhagen, Denmark (Messrs Jamal Uddin and Joshi, Ms Rossau, and Drs Taylor and Zwisler); Department of Noncommunicable Disease, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh (Mr Moniruzzaman and Dr Jalal Uddin); Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom (Dr Taylor); and Institute of Health and Well Being, University of Glasgow, Glasgow, United Kingdom (Dr Taylor).
Abstract
PURPOSE: Cardiovascular disease is the leading cause of mortality and morbidity in lower-middle income countries (LMICs), including Bangladesh. Cardiac rehabilitation (CR) as part of secondary prevention of cardiovascular disease has been shown to reduce mortality and morbidity and improve quality of life and exercise capacity. However, to date, very few controlled trials of CR have been conducted in LMICs. METHODS: A quasi-randomized controlled trial comparing home-based CR plus usual care with usual care alone was undertaken with patients following coronary artery bypass graft surgery. Participants in the CR group received an in-hospital CR class and were introduced to a locally developed educational booklet with details of a home-based exercise program and then received monthly telephone calls for 12 mo. Primary outcomes were coronary heart disease (CHD) risk factors, health-related quality of life (HRQOL), and mental well-being. Maximal oxygen uptake as a measure of exercise capacity was a secondary outcome. RESULTS:In total, 142 of 148 eligible participants took part in the trial (96%); 71 in each group. At 12-mo follow-up, 61 patients (86%) in the CR group and 40 (56%) in the usual care group provided complete outcome data. Greater reductions in CHD risk factors and improvements in HRQOL, mental well-being, and exercise capacity were seen for the CR group compared with the usual care group. CONCLUSIONS: In the context of a single-center LMIC setting, this study demonstrated the feasibility of home-based CR programs and offers a model of service delivery that could be replicated on a larger scale.
RCT Entities:
PURPOSE:Cardiovascular disease is the leading cause of mortality and morbidity in lower-middle income countries (LMICs), including Bangladesh. Cardiac rehabilitation (CR) as part of secondary prevention of cardiovascular disease has been shown to reduce mortality and morbidity and improve quality of life and exercise capacity. However, to date, very few controlled trials of CR have been conducted in LMICs. METHODS: A quasi-randomized controlled trial comparing home-based CR plus usual care with usual care alone was undertaken with patients following coronary artery bypass graft surgery. Participants in the CR group received an in-hospital CR class and were introduced to a locally developed educational booklet with details of a home-based exercise program and then received monthly telephone calls for 12 mo. Primary outcomes were coronary heart disease (CHD) risk factors, health-related quality of life (HRQOL), and mental well-being. Maximal oxygen uptake as a measure of exercise capacity was a secondary outcome. RESULTS: In total, 142 of 148 eligible participants took part in the trial (96%); 71 in each group. At 12-mo follow-up, 61 patients (86%) in the CR group and 40 (56%) in the usual care group provided complete outcome data. Greater reductions in CHD risk factors and improvements in HRQOL, mental well-being, and exercise capacity were seen for the CR group compared with the usual care group. CONCLUSIONS: In the context of a single-center LMIC setting, this study demonstrated the feasibility of home-based CR programs and offers a model of service delivery that could be replicated on a larger scale.
Authors: Grace Dibben; James Faulkner; Neil Oldridge; Karen Rees; David R Thompson; Ann-Dorthe Zwisler; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2021-11-06
Authors: Randal J Thomas; Cara E Petersen; Thomas P Olson; Alexis L Beatty; Rongjing Ding; Marta Supervia Journal: J Cardiopulm Rehabil Prev Date: 2021-11-01 Impact factor: 3.646