Abstract 11184: Effects of Supervised Exercise on Select Outcomes for Patients With Heart Failure
EFFECTS OF SUPERVISED EXERCISE ON SELECT OUTCOMES FOR PATIENTS WITH HEART FAILURE Background: There is an urgent need to implement strategies to improve outcomes for heart failure (HF) patients. Supervised exercise programs are a Class A recommendation for a multitude of cardiac conditions and are reimbursable by Medicare and most insurance carriers. Stating lack of evidence of improved patient outcomes, the Centers for Medicare and Medicaid Services deny/limit HF as a reimbursable diagnosis for such programs.
Hypothesis: To determine the impact of a supervised exercise program for HF patients on the functional capacity, quality of life, level of depression, and rate of hospital readmission.
Methods: A before-after cohort study of HF patients who participated in an outpatient phase II cardiac rehabilitation program was done. HF patients (n = 70) with stable New York Heart Association class II-IV diastolic or systolic heart failure were enrolled during an outpatient nurse navigation contact or referral by cardiologists. Surveys to assess quality of life and level of depression (the Kansas City Cardiomyopathy Questionnaire (KCCQ) and Patient Health Questionnaire-9 (PHQ-9)) were used. Functional level was measured using the 6 Minute Walk Distance (6MWD) test. Readmission data were collected from medical records.
Results: Depression (PHQ-9) scores dropped (t = 5.86, p < .01). Quality of life scores (KCCQ) improved with for all KCCQ subsets (except system stability) including physical limitation (t = -7.86, p < .01), system frequency (t = -5.91, p < .01), system burden (t = -5.95, p < .01), total system (t = -6.62, p < .01), self-efficacy (t = -5.04, p < .01), quality of life (t = -7.35, p < .01), social limitation (t = -5.66, p < .01), overall summary (t value = -7.73, p < .01), and clinical summary (t value = -7.67, p < .01). Functional status improved with increase in 6MWD (t = -8.55, p < .01). Readmission rates improved with admission encounters dropping (t = 6.07, p < .01) and fewer number of days hospitalized (t = 4.96, p < .01).
Conclusions: Participation in a supervised exercise program resulted in clinically and statistically significant positive changes in depression scores, quality of life scores, functional status, and rates of readmission.
Author Disclosures: K. Roberts: None.
- © 2016 by American Heart Association, Inc.