Abstract
BackgroundThe goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.MethodsPatients (N = 487, 64.7% male, age 60.9 ± 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].ResultsAll MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.ConclusionThese findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.
Highlights
The goal of cardiac rehabilitation programs is to prolong life and to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL)
A recently published meta-analysis showed that 12 out of 12 exercise-based outpatient CR programs improved health-related quality of life (HRQL) but the magnitude of improvement in HRQL with cardiac rehabilitation exceeded that of the controls in only two trials [4]
Inpatient as well as outpatient CR programs are provided in Austria [7] and there is evidence from a non-randomized study that both types of CR programs adequately improve the short term (3-month) outcome of HRQL [8]
Summary
The goal of cardiac rehabilitation programs is to prolong life and to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The objectives of cardiac rehabilitation (CR) include the reduction of symptoms and the improvement of physical functioning and general wellbeing [1,2]. These outcomes are typically considered to be patient-reported outcomes (PRO) and have top-tier priority when it comes to assessing quality in cardiovascular care [3]. Short-term studies including PRO and clinical data for the major six Austrian cardiac inpatient rehabilitation centers have documented statistically significant and clinical important improvements in HRQL and reduction of risk factors in an unselected patient group [9]
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