Jhawar Manish, Chan Albert, Christianson Leif, Mehra Ankit, Aggarwal Kul, Dellsperger Kevin, Chockalingam Anand
University of Missouri - Columbia, USA.
Mo Med. 2013 Jan-Feb;110(1):71-3.
Cardiac rehabilitation (CR) is underutilized across the United States. Reported national average varies from 14-35% after acute myocardial infraction and 31% after coronary artery bypass grafting surgery. No study to date has examined the utilization of CR in eligible veteran population. In this retrospective study, computerized veteran medical records at a single Veterans Administration (VA) hospital were screened between January 1, 2006 and December 31, 2009. Patients who met the inclusion and exclusion criteria were surveyed telephonically and asked a series of questions relating to delivery and utilization of phase II CR. Data was collected using a pre-printed questionnaire and patient responses were number coded. Utilization rate of phase II CR in veterans was noted to be 21%. Common reasons reported for underutilization of CR included time and distance problems, orthopedic- and stroke-related muscle weakness and lack of motivation. Participation in Phase II CR led to better adherence to exercise long term. Also, 65-70% of the veterans expressed interest in a tailored home based CR program. CR is underutilized in eligible veterans. Compliance could possibly be improved if the veterans were offered a tailored CR program.
心脏康复(CR)在美国未得到充分利用。据报道,急性心肌梗死后全国平均利用率在14%至35%之间,冠状动脉搭桥手术后为31%。迄今为止,尚无研究调查符合条件的退伍军人人群中CR的利用率。在这项回顾性研究中,对一家退伍军人事务(VA)医院2006年1月1日至2009年12月31日期间的计算机化退伍军人医疗记录进行了筛查。对符合纳入和排除标准的患者进行了电话调查,并询问了一系列与二期CR的提供和利用相关的问题。使用预先印制的问卷收集数据,患者的回答进行数字编码。退伍军人二期CR的利用率为21%。报告的CR未得到充分利用的常见原因包括时间和距离问题、与骨科和中风相关的肌肉无力以及缺乏动力。参与二期CR能使长期锻炼的依从性更好。此外,65%至70%的退伍军人对量身定制的居家心脏康复计划表示感兴趣。符合条件的退伍军人中CR未得到充分利用。如果为退伍军人提供量身定制的CR计划,依从性可能会得到改善。