tetano
Editor, Senior Moderator
Eur J Cardiovasc Nurs
. 2022 Feb 8;zvac006.
doi: 10.1093/eurjcn/zvac006. Online ahead of print.
Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences
Dion Candelaria[SUP] 1 2 [/SUP], Ann Kirkness[SUP] 3 [/SUP], Maura Farrell[SUP] 3 [/SUP], Kellie Roach[SUP] 4 [/SUP], Louise Gooley[SUP] 5 [/SUP], Ashlee Fletcher[SUP] 3 [/SUP], Sarah Ashcroft[SUP] 3 [/SUP], Helen Glinatsis[SUP] 3 [/SUP], Christine Bruntsch[SUP] 3 [/SUP], Jayne Roberts[SUP] 3 [/SUP], Sue Randall[SUP] 1 [/SUP], Janice Gullick[SUP] 1 [/SUP], Laila Akbar Ladak[SUP] 1 6 [/SUP], Keith Soady[SUP] 7 [/SUP], Robyn Gallagher[SUP] 1 2 [/SUP]
Affiliations
Abstract
Aims: Enforced suspension and reduction of in-person cardiac rehabilitation (CR) services during the coronavirus disease-19 (COVID-19) pandemic restrictions required rapid implementation of remote delivery methods, thus enabling a cohort comparison of in-person vs. remote-delivered CR participants. This study aimed to examine the health-related quality of life (HRQL) outcomes and patient experiences comparing these delivery modes.
Methods and results: Participants across four metropolitan CR sites receiving in-person (December 2019 to March 2020) or remote-delivered (April to October 2020) programmes were assessed for HRQL (Short Form-12) at CR entry and completion. A General Linear Model was used to adjust for baseline group differences and qualitative interviews to explore patient experiences. Participants (n = 194) had a mean age of 65.94 (SD 10.45) years, 80.9% males. Diagnoses included elective percutaneous coronary intervention (40.2%), myocardial infarction (33.5%), and coronary artery bypass grafting (26.3%). Remote-delivered CR wait times were shorter than in-person [median 14 (interquartile range, IQR 10-21) vs. 25 (IQR 16-38) days, P < 0.001], but participation by ethnic minorities was lower (13.6% vs. 35.2%, P < 0.001). Remote-delivered CR participants had equivalent benefits to in-person in all HRQL domains but more improvements than in-person in Mental Health, both domain [mean difference (MD) 3.56, 95% confidence interval (CI) 1.28, 5.82] and composite (MD 2.37, 95% CI 0.15, 4.58). From qualitative interviews (n = 16), patients valued in-person CR for direct exercise supervision and group interactions, and remote-delivered for convenience and flexibility (negotiable contact times).
Conclusion: Remote-delivered CR implemented during COVID-19 had equivalent, sometimes better, HRQL outcomes than in-person, and shorter wait times. Participation by minority groups in remote-delivered modes are lower. Further research is needed to evaluate other patient outcomes.
Keywords: COVID-19; Cardiac rehabilitation; Health-related quality of life; Patient experiences; Remote delivery.
. 2022 Feb 8;zvac006.
doi: 10.1093/eurjcn/zvac006. Online ahead of print.
Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences
Dion Candelaria[SUP] 1 2 [/SUP], Ann Kirkness[SUP] 3 [/SUP], Maura Farrell[SUP] 3 [/SUP], Kellie Roach[SUP] 4 [/SUP], Louise Gooley[SUP] 5 [/SUP], Ashlee Fletcher[SUP] 3 [/SUP], Sarah Ashcroft[SUP] 3 [/SUP], Helen Glinatsis[SUP] 3 [/SUP], Christine Bruntsch[SUP] 3 [/SUP], Jayne Roberts[SUP] 3 [/SUP], Sue Randall[SUP] 1 [/SUP], Janice Gullick[SUP] 1 [/SUP], Laila Akbar Ladak[SUP] 1 6 [/SUP], Keith Soady[SUP] 7 [/SUP], Robyn Gallagher[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35137049
- DOI: 10.1093/eurjcn/zvac006
Abstract
Aims: Enforced suspension and reduction of in-person cardiac rehabilitation (CR) services during the coronavirus disease-19 (COVID-19) pandemic restrictions required rapid implementation of remote delivery methods, thus enabling a cohort comparison of in-person vs. remote-delivered CR participants. This study aimed to examine the health-related quality of life (HRQL) outcomes and patient experiences comparing these delivery modes.
Methods and results: Participants across four metropolitan CR sites receiving in-person (December 2019 to March 2020) or remote-delivered (April to October 2020) programmes were assessed for HRQL (Short Form-12) at CR entry and completion. A General Linear Model was used to adjust for baseline group differences and qualitative interviews to explore patient experiences. Participants (n = 194) had a mean age of 65.94 (SD 10.45) years, 80.9% males. Diagnoses included elective percutaneous coronary intervention (40.2%), myocardial infarction (33.5%), and coronary artery bypass grafting (26.3%). Remote-delivered CR wait times were shorter than in-person [median 14 (interquartile range, IQR 10-21) vs. 25 (IQR 16-38) days, P < 0.001], but participation by ethnic minorities was lower (13.6% vs. 35.2%, P < 0.001). Remote-delivered CR participants had equivalent benefits to in-person in all HRQL domains but more improvements than in-person in Mental Health, both domain [mean difference (MD) 3.56, 95% confidence interval (CI) 1.28, 5.82] and composite (MD 2.37, 95% CI 0.15, 4.58). From qualitative interviews (n = 16), patients valued in-person CR for direct exercise supervision and group interactions, and remote-delivered for convenience and flexibility (negotiable contact times).
Conclusion: Remote-delivered CR implemented during COVID-19 had equivalent, sometimes better, HRQL outcomes than in-person, and shorter wait times. Participation by minority groups in remote-delivered modes are lower. Further research is needed to evaluate other patient outcomes.
Keywords: COVID-19; Cardiac rehabilitation; Health-related quality of life; Patient experiences; Remote delivery.