van Erck Dennis, Terbraak Michel, Dolman Christine D, Weijs Peter J M, Henriques José P, Delewi Ronak, Verweij Lotte, Jepma Patricia, Scholte Op Reimer Wilma J M, Schoufour Josje D
Cardiology, Amsterdam University Medical Centers, University of Amsterdam, 1105AZ Amsterdam, The Netherlands.
Faculty Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1105BD Amsterdam, The Netherlands.
Geriatrics (Basel). 2023 May 13;8(3):53. doi: 10.3390/geriatrics8030053.
Referral to home-based cardiac rehabilitation (HBCR) is low among older and frailer patients due to low expectations regarding adherence by healthcare professionals. The aim of this study was to determine adherence to HBCR when old and frail patients are referred, and to explore any differences in baseline characteristics between adherent and nonadherent patients. Data of the Cardiac Care Bridge were used (Dutch trial register NTR6316). The study included hospitalized cardiac patients ≥ 70 years old and at high risk of functional loss. Adherence to HBCR was confirmed when two-thirds of the intended nine sessions were followed. Of the 153 patients included (age: 82 ± 6 years, 54% female), 29% could not be referred due to death before referral, not returning home, or practical problems. Of the 109 patients who were referred, 67% adhered. Characteristics associated with non-adherence were older age (84 ± 6 vs. 82 ± 6, = 0.05) and higher handgrip strength in men (33 ± 8 vs. 25 ± 11, = 0.01). There was no difference in comorbidity, symptoms, or physical capacity. Based on these observations, most older cardiac patients who return home after hospital admission appear to adhere to HBCR after referral, suggesting that most older cardiac patients are motivated and capable of receiving HBCR.
由于医护人员对老年体弱患者坚持家庭心脏康复（HBCR）的期望较低，因此转诊至HBCR的老年体弱患者较少。本研究的目的是确定老年体弱患者转诊后对HBCR的坚持情况，并探讨坚持和不坚持的患者在基线特征上的差异。使用了心脏护理桥梁的数据（荷兰试验注册编号NTR6316）。该研究纳入了年龄≥70岁且有功能丧失高风险的住院心脏病患者。当完成预定的九次疗程中的三分之二时，确认对HBCR的坚持情况。在纳入的153例患者中（年龄：82±6岁，54%为女性），29%由于转诊前死亡、未回家或实际问题而无法转诊。在转诊的109例患者中，67%坚持治疗。与不坚持相关的特征为年龄较大（84±6岁对82±6岁，P = 0.05）以及男性握力较高（33±8对25±11，P = 0.01）。在合并症、症状或身体能力方面没有差异。基于这些观察结果，大多数入院后回家的老年心脏病患者在转诊后似乎坚持HBCR，这表明大多数老年心脏病患者有动机且有能力接受HBCR。
