The impact of professional status on the effects of and adherence to the outpatient followed by home-based telemonitored cardiac rehabilitation in patients referred by a social insurance institution

• Authors: Dominika Szalewska , Piotr Niedoszytko , Katarzyna Gierat-Haponiuk

Abstracts

EN

Objectives Legislators and policymakers have expressed strong interest in intervention programs to reduce dependence on social disability benefits. Hybrid: ambulatory followed by home-based cardiac telerehabilitation – hybrid cardiac rehabilitation (HCR) seems to be a novel alternative for standard cardiac rehabilitation for patients with cardiovascular diseases (CVD) as a form of pension prevention paid by the Social Insurance Institution (SII). The kind of professional status may bias the motivation to return to work after HCR. The aim of our study was to evaluate whether the professional status can affect the effects of HCR. Material and Methods One hundred fifty-two patients with CVD referred by the SII for a 5-week HCR were qualified for the study. Patients (87.7% males), aged 57.31±5.61 years, were divided into 2 subgroups: W) white-collar employees (N = 22) and B) blue-collar employees (N = 130). To evaluate functional capacity, an exercise test on a treadmill was used. Results The number of days of absence in the cardiac rehabilitation program did not differ between the groups (mean ± standard deviation – B: 1.09±3.10 days, W: 1.95±3.64 days). There were significant improvements (p < 0.05) in measured variables after HCR in both (W and B) groups (max workload: 8.21±2.88 METs (measured in metabolic equivalents) vs. 9.6±2.49 METs, 7.76±2.51 METs vs. 8.73±2.7 METs, resting heart rate (RHR): 77±16.22 bpm vs. 69.94±12.93 bpm, 79.59±14 bpm vs. 75.24±11.87 bpm; double product, i.e., product of heart rate and systolic BP (DP rest) 10 815.22±2968.24 vs. 9242.94±1923.08, 10 927.62±2508.47 vs. 9929.7±2304.94). In group B, a decrease in systolic blood pressure (BP syst. – 137.03±17.14 mm Hg vs. 131.82±21.13 mm Hg), heart rate recovery in the 1st minute after the end of peak exercise (HRR1) (99.38±19.25 vs. 93.9±19.48) and New York Heart Association (NYHA) class (1.22±0.53 vs. 1.11±0.36) was observed. In group W, a decrease in diastolic blood pressure (BP diast.) at rest was observed (88.28±9.79 mm Hg vs. 83.39±8.95 mm Hg). The decrease in resting HR was significantly greater in group W (69.94±12.93 vs. 75.24±11.87, p = 0.034). Conclusions Hybrid cardiac rehabilitation is feasible and safe with high adherence to the program regardless of the patient’s professional status. Professional status did not influence the beneficial effect of HCR on exercise tolerance.

Keywords

EN

rehabilitation; Coronary artery disease; telemedicine; cardiac rehabilitation; social benefit; occupational status

• Publisher: Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
• Journal: International Journal of Occupational Medicine and Environmental Health
• Year: 2015
• Volume: 28
• Issue: 4
• Pages: 761-770

Dates

published

2015

Contributors

author

Dominika Szalewska

• Medical University of Gdańsk, Gdańsk, Poland (Department of Rehabilitation)

author

Piotr Niedoszytko

• Medical University of Gdańsk, Gdańsk, Poland (Department of Rehabilitation)

author

Katarzyna Gierat-Haponiuk

• Medical University of Gdańsk, Gdańsk, Poland (Department of Rehabilitation)

Identifiers

DOI

10.13075/ijomeh.1896.00494

Biblioteka Nauki

2177231