Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff

Ray W. Squires, Aura Montero-Gomez, Thomas G. Allison, Randal J. Thomas

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

■ PURPOSE: Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. ■ METHODS: Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. ■ RESULTS: At 3 years, aspirin usage was 91%, statin usage 91%, β-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 ± 23 mg/dL, systolic blood pressure was 126 ± 19 mm Hg, and body mass index was 29.0 ± 5.1 kg/m2. Exercise training averaged 139 ± 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. ■ CONCLUSIONS: Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

Original languageEnglish (US)
Pages (from-to)180-186
Number of pages7
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume28
Issue number3
DOIs
StatePublished - May 2008

Fingerprint

Disease Management
Coronary Disease
Secondary Prevention
LDL Cholesterol
Exercise
Blood Pressure
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Mortality
Angiotensin-Converting Enzyme Inhibitors
Aspirin
Cardiac Rehabilitation
Body Mass Index
Outpatients
Randomized Controlled Trials
Outcome Assessment (Health Care)

Keywords

  • Cardiac rehabilitation
  • Long-term disease management

ASJC Scopus subject areas

  • Rehabilitation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff. / Squires, Ray W.; Montero-Gomez, Aura; Allison, Thomas G.; Thomas, Randal J.

In: Journal of Cardiopulmonary Rehabilitation and Prevention, Vol. 28, No. 3, 05.2008, p. 180-186.

Research output: Contribution to journalArticle

Squires, Ray W. ; Montero-Gomez, Aura ; Allison, Thomas G. ; Thomas, Randal J. / Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff. In: Journal of Cardiopulmonary Rehabilitation and Prevention. 2008 ; Vol. 28, No. 3. pp. 180-186.
@article{35bceaebd0f74965897ad70d688d220e,
title = "Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff",
abstract = "■ PURPOSE: Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. ■ METHODS: Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. ■ RESULTS: At 3 years, aspirin usage was 91{\%}, statin usage 91{\%}, β-blocker usage 78{\%}, and angiotensin-converting enzyme inhibitor usage 76{\%}. Low-density lipoprotein cholesterol was 90 ± 23 mg/dL, systolic blood pressure was 126 ± 19 mm Hg, and body mass index was 29.0 ± 5.1 kg/m2. Exercise training averaged 139 ± 123 minutes per week. Annual mortality was 1.9{\%}. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. ■ CONCLUSIONS: Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.",
keywords = "Cardiac rehabilitation, Long-term disease management",
author = "Squires, {Ray W.} and Aura Montero-Gomez and Allison, {Thomas G.} and Thomas, {Randal J.}",
year = "2008",
month = "5",
doi = "10.1097/01.HCR.0000320068.35728.12",
language = "English (US)",
volume = "28",
pages = "180--186",
journal = "Journal of Cardiopulmonary Rehabilitation and Prevention",
issn = "1932-7501",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff

AU - Squires, Ray W.

AU - Montero-Gomez, Aura

AU - Allison, Thomas G.

AU - Thomas, Randal J.

PY - 2008/5

Y1 - 2008/5

N2 - ■ PURPOSE: Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. ■ METHODS: Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. ■ RESULTS: At 3 years, aspirin usage was 91%, statin usage 91%, β-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 ± 23 mg/dL, systolic blood pressure was 126 ± 19 mm Hg, and body mass index was 29.0 ± 5.1 kg/m2. Exercise training averaged 139 ± 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. ■ CONCLUSIONS: Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

AB - ■ PURPOSE: Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. ■ METHODS: Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. ■ RESULTS: At 3 years, aspirin usage was 91%, statin usage 91%, β-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 ± 23 mg/dL, systolic blood pressure was 126 ± 19 mm Hg, and body mass index was 29.0 ± 5.1 kg/m2. Exercise training averaged 139 ± 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. ■ CONCLUSIONS: Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

KW - Cardiac rehabilitation

KW - Long-term disease management

UR - http://www.scopus.com/inward/record.url?scp=53449093999&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53449093999&partnerID=8YFLogxK

U2 - 10.1097/01.HCR.0000320068.35728.12

DO - 10.1097/01.HCR.0000320068.35728.12

M3 - Article

VL - 28

SP - 180

EP - 186

JO - Journal of Cardiopulmonary Rehabilitation and Prevention

JF - Journal of Cardiopulmonary Rehabilitation and Prevention

SN - 1932-7501

IS - 3

ER -