Abstract 9479: The Impact of a Progressive, Tailored Intervention on Cardiac Rehabilitation Enrollment After Acute Coronary Syndrome: The ICU-Transit Randomized Trial
Introduction: Short hospital stays for acute coronary syndrome (ACS) patients diminish opportunities to intervene on risk factors before hospital discharge. It is well documented that outpatient cardiac rehabilitation (rehab) can decrease recurrence of coronary events by as much as 25%, but remains underused.
Hypothesis: We assessed the hypothesis that a nursing intervention focusing on patients′ individual perceptions of their disease and its treatment would increase rehab enrollment after ACS. Gender differences were also explored.
Methods: We randomised 242 ACS patients (207 men) admitted in a specialized tertiary cardiac center. Randomisation to Intervention vs usual care occurred before discharge. The intervention protocol consisted of 3 individual encounters, each lasting a mean of 40 minutes. These encounters progressively addressed topics ranging from clinical issues that may occur soon after discharge to coping with risk factors and rehab opportunities in the later encounters. The primary outcome was enrollment into a free rehab program offered to all subjects 6 weeks after discharge.
Results: We found a significant increase in rehab enrollment in the intervention group (45%) vs the control group (24%, p = .001). The interaction of gender by group was not significant (p = .13). However descriptive data show differences in favor of the intervention group in men (46 vs 22%) with no differences in women (39 vs 42%).
Conclusions: Progressive, individualized interventions by nurses result in better rehab enrollment, thereby potentially improving long term outcome. The intervention's impact appeared less evident in women. Although this may be related to the characteristics and size of the sample, gender differences in rehab enrollment remain a challenge and deserve further investigation.
- © 2010 by American Heart Association, Inc.