Kehler Dustin Scott, Kent Dave, Beaulac Julie, Strachan Leisha, Wangasekara Nilu, Chapman Soyun, Hiebert Brett, Lamont Darlene, Lerner Neal, Boreskie Sue, Avery Lorraine, Duhamel Todd A
Faculty of Kinesiology & Recreation Management, Health, Leisure & Human Performance Research Institute, University of Manitoba, Winnepeg, Canada (Messrs Kehler and Kent, Drs Strachan and Duhamel, and Ms Chapman); St. Boniface Hospital Research Centre, Institute of Cardiovascular Sciences, Winnepeg, Manitoba, Canada (Messrs Kehler, Kent, and Wangasekara, Ms Chapman, and Dr Duhamel); Department of Clinical Health Psychology, University of Manitoba, Winnepeg, Canada (Dr Beaulac); St. Boniface General Hospital, Winnipeg, Manitoba, Canada (Mr Hiebert); Reh-Fit Centre, Winnipeg, Manitoba, Canada (Mss Lamont and Boreskie, and Dr Lerner); Winnipeg Regional Health Authority Cardiac Sciences Program, Winnipeg, Manitoba, Canada (Dr Avery); and Department of Physiology, University of Manitoba, Winnipeg, Canada (Dr Duhamel).
J Cardiopulm Rehabil Prev. 2017 Jul;37(4):250-256. doi: 10.1097/HCR.0000000000000232.
The purpose of this study was to examine whether meeting the Canadian Cardiovascular Society (CCS) ≤60-day wait time from cardiac rehabilitation (CR) referral to enrollment is associated with CCS patient-level quality indicator outcomes.
This pilot observational study consisted of 69 participants entering CR separated into 2 groups based on wait time (≤60-day, n = 45; >60-day, n = 24). Data were collected at baseline, and 1, 4 (CR completion), 6, and 12 months after baseline. Quality indicators for achieving a 0.5 peak metabolic equivalent (MET) improvement at CR completion, physical activity of 150 min/wk of moderate-vigorous physical activity, and CR adherence were assessed. Depressive symptoms were assessed with the Patient Health Questionnaire.
Sixty participants completed the study (≤60-day, n = 40; >60-day, n = 20). In the ≤60-day group, 92% of participants achieved the 0.5 MET improvement upon CR completion; whereas 60% of the >60-day group met this criteria (P ≤ .05). For the 150 min/wk of moderate-vigorous physical activity and CR adherence, both groups were not significantly different at any time. Elevated depressive symptoms were initially observed in 45% of participants in the ≤60-day group and 35% in the >60-day group (NS) and decreased to 8% in the ≤60-day group compared with 30% in the >60-day group at 12 months (P ≤ .05).
Meeting the CCS 60-day acceptable wait time is associated with improvements in METs and depressive symptoms, but not with physical activity or CR adherence. A larger observational study is warranted to explore patient-level CCS quality indicators during and after CR.
本研究旨在探讨从心脏康复（CR）转诊到登记入组是否满足加拿大心血管学会（CCS）规定的≤60天等待时间与CCS患者层面质量指标结果之间的关联。
这项试点观察性研究包括69名进入CR的参与者，根据等待时间分为两组（≤60天，n = 45；>60天，n = 24）。在基线时以及基线后1、4（CR完成时）、6和12个月收集数据。评估了CR完成时达到代谢当量（MET）峰值提高0.5、每周进行150分钟中等强度至剧烈强度身体活动以及CR依从性的质量指标。使用患者健康问卷评估抑郁症状。
60名参与者完成了研究（≤60天，n = 40；>60天，n = 20）。在≤60天组中，92%的参与者在CR完成时实现了MET提高0.5；而>60天组中60%的参与者达到了这一标准（P≤0.05）。对于每周150分钟中等强度至剧烈强度身体活动和CR依从性，两组在任何时间均无显著差异。≤60天组中45%的参与者和>60天组中35%的参与者最初观察到抑郁症状升高（无显著性差异），在12个月时，≤60天组降至8%，而>60天组为30%（P≤0.05）。
满足CCS规定的60天可接受等待时间与MET改善和抑郁症状改善相关，但与身体活动或CR依从性无关。有必要进行更大规模的观察性研究，以探索CR期间及之后患者层面的CCS质量指标。
