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Published in: BMC Cardiovascular Disorders 1/2018

Open Access 01-12-2018 | Research article

Effect of the patient education - Learning and Coping strategies - in cardiac rehabilitation on return to work at one year: a randomised controlled trial show (LC-REHAB)

Authors: Birgitte Laier Bitsch, Claus Vinther Nielsen, Christina Malmose Stapelfeldt, Vibeke Lynggaard

Published in: BMC Cardiovascular Disorders | Issue 1/2018

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Abstract

Background

Personal resources are identified as important for the ability to return to work (RTW) for patients with ischaemic heart disease (IHD) or heart failure (HF) undergoing cardiac rehabilitation (CR). The patient education ‘Learning and Coping’ (LC) addresses personal resources through a pedagogical approach. This trial aimed to assess effect of adding LC strategies in CR compared to standard CR measured on RTW status at one-year follow-up after CR.

Methods

In an open parallel randomised controlled trial, patients with IHD or HF were block-randomised in a 1:1 ratio to the LC arm (LC plus CR) or the control arm (CR alone) across three Danish hospital units. Eligible patients were aged 18 to ≤60 and had not left the labour market. The intervention was developed from an inductive pedagogical approach consisting of individual interviews and group based teaching by health professionals with experienced patients as co-educators. The control arm consisted of deductive teaching (standard CR). RTW status was derived from the Danish Register for Evaluation of Marginalisation (DREAM). Blinding was not possible. The effect was evaluated by logistic regression analysis and reported as crude and adjusted odds ratios (OR) with 95% confidence interval (CI).

Results

The population for the present analysis was N = 244 (LC arm: n = 119 versus control arm: n = 125). No difference in RTW status was found at one year across arms (LC arm: 64.7% versus control arm: 68.8%, adjusted odds ratio OR: 0.76, 95% CI: 0.43-1.31).

Conclusion

Addition of LC strategies in CR showed no improvement in RTW at one year follow-up.

Trial registration

www.​clinicaltrials.​gov identifier NCT01668394. First Posted: August 20, 2012.
Literature
2.
go back to reference Anderson L, Oldridge N, Thompson DR, Zwisler A, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016;67(1):1.CrossRefPubMed Anderson L, Oldridge N, Thompson DR, Zwisler A, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016;67(1):1.CrossRefPubMed
3.
go back to reference MFP. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts). Int J Behav Med. 2017;24(3):321.CrossRef MFP. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts). Int J Behav Med. 2017;24(3):321.CrossRef
4.
go back to reference Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Leal J, Luengo-Fernandez R, Burns R, Rayner M, Townsend N. European cardiovascular disease statistics 2017. Brussels: European Heart Network; 2017. Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Leal J, Luengo-Fernandez R, Burns R, Rayner M, Townsend N. European cardiovascular disease statistics 2017. Brussels: European Heart Network; 2017.
5.
go back to reference Cieza A, Stucki A, Geyh S, Berteanu M, Quittan M, Simon A, et al. ICF core sets for chronic ischaemic heart disease. J Rehabil Med. 2004;36(Supplement 44):94–9.CrossRef Cieza A, Stucki A, Geyh S, Berteanu M, Quittan M, Simon A, et al. ICF core sets for chronic ischaemic heart disease. J Rehabil Med. 2004;36(Supplement 44):94–9.CrossRef
6.
go back to reference Anderson L, Brown JPR, Clark AM, Dalal H, Rossau HK, Bridges C, Taylor RS. Patient education in the management of coronary heart disease. The Cochrane database of systematic reviews 2017 28 June;Cochrane Database of Systematic Reviews 2017(Issue 6. DOI: https://doi.org/10.1002/14651858):CD008895. Anderson L, Brown JPR, Clark AM, Dalal H, Rossau HK, Bridges C, Taylor RS. Patient education in the management of coronary heart disease. The Cochrane database of systematic reviews 2017 28 June;Cochrane Database of Systematic Reviews 2017(Issue 6. DOI: https://​doi.​org/​10.​1002/​14651858):CD008895.
7.
go back to reference Commodore-Mensah Y, Dennison Himmelfarb CR. Patient education strategies for hospitalized cardiovascular patients: a systematic review. J Cardiovasc Nurs. 2012;27(2):154–74.CrossRefPubMed Commodore-Mensah Y, Dennison Himmelfarb CR. Patient education strategies for hospitalized cardiovascular patients: a systematic review. J Cardiovasc Nurs. 2012;27(2):154–74.CrossRefPubMed
8.
go back to reference Loisel P, Anema JR, ebrary I. Handbook of work disability : prevention and management. New York: Springer; 2013.CrossRef Loisel P, Anema JR, ebrary I. Handbook of work disability : prevention and management. New York: Springer; 2013.CrossRef
9.
go back to reference Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016 Nov;23(16):1715–33.CrossRefPubMed Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016 Nov;23(16):1715–33.CrossRefPubMed
10.
go back to reference Mital A, Desai A, Mital A. Return to work after a coronary event. J Cardpulm Rehabil. 2004;24(6):365–73.CrossRef Mital A, Desai A, Mital A. Return to work after a coronary event. J Cardpulm Rehabil. 2004;24(6):365–73.CrossRef
11.
go back to reference Kruse M, Sørensen J, Davidsen M, Gyrd-Hansen D. Short and long-term labour market consequences of coronary heart disease: a register-based follow-up study. Eur J Cardiovasc Prev Rehabil. 2009;16(3):387–91.CrossRefPubMed Kruse M, Sørensen J, Davidsen M, Gyrd-Hansen D. Short and long-term labour market consequences of coronary heart disease: a register-based follow-up study. Eur J Cardiovasc Prev Rehabil. 2009;16(3):387–91.CrossRefPubMed
12.
go back to reference Rørth R, Wong C, Kragholm K, Fosbøl EL, Mogensen UM, Lamberts M, et al. Return to the workforce after first hospitalization for heart failure: a Danish Nationwide cohort study. Circulation. 2016;134(14):999–1009.CrossRefPubMed Rørth R, Wong C, Kragholm K, Fosbøl EL, Mogensen UM, Lamberts M, et al. Return to the workforce after first hospitalization for heart failure: a Danish Nationwide cohort study. Circulation. 2016;134(14):999–1009.CrossRefPubMed
13.
go back to reference Biering K, Hjøllund NH, Lund T. Methods in measuring return to work: a comparison of measures of return to work following treatment of coronary heart disease. J Occup Rehabil. 2013;23(3):400–5.CrossRefPubMed Biering K, Hjøllund NH, Lund T. Methods in measuring return to work: a comparison of measures of return to work following treatment of coronary heart disease. J Occup Rehabil. 2013;23(3):400–5.CrossRefPubMed
14.
go back to reference Fonager K, Lundbye-Christensen S, Andreasen JJ, Futtrup M, Christensen AL, Ahmad K, et al. Work status and return to the workforce after coronary artery bypass grafting and/or heart valve surgery: a one-year-follow up study. Rehabil Res Pract. 2014;2014:631842.PubMedPubMedCentral Fonager K, Lundbye-Christensen S, Andreasen JJ, Futtrup M, Christensen AL, Ahmad K, et al. Work status and return to the workforce after coronary artery bypass grafting and/or heart valve surgery: a one-year-follow up study. Rehabil Res Pract. 2014;2014:631842.PubMedPubMedCentral
15.
go back to reference O'Hagan FT, Thomas SG. Work adjustment in cardiovascular disease: job characteristics and social support. J Cardiopulm Rehabil Prev. 2011;31(6):358–64.CrossRefPubMed O'Hagan FT, Thomas SG. Work adjustment in cardiovascular disease: job characteristics and social support. J Cardiopulm Rehabil Prev. 2011;31(6):358–64.CrossRefPubMed
16.
17.
go back to reference Bültman U, Brouwer Sandra. Individual-level psychosocial factors and work disability prevention, chapter 10. In: Loisel P, Anema JR, ebrary I, editors. Handbook of work disability: prevention and management New York: Springer; 2013. p. 149. Bültman U, Brouwer Sandra. Individual-level psychosocial factors and work disability prevention, chapter 10. In: Loisel P, Anema JR, ebrary I, editors. Handbook of work disability: prevention and management New York: Springer; 2013. p. 149.
18.
go back to reference Fors A, Ekman I, Taft C, Björkelund C, Frid K, Larsson ME, et al. Person-centred care after acute coronary syndrome, from hospital to primary care - a randomised controlled trial. Int J Cardiol. 2015;187:693–9.CrossRefPubMed Fors A, Ekman I, Taft C, Björkelund C, Frid K, Larsson ME, et al. Person-centred care after acute coronary syndrome, from hospital to primary care - a randomised controlled trial. Int J Cardiol. 2015;187:693–9.CrossRefPubMed
19.
go back to reference Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Further development of an illness perception intervention for myocardial infarction patients: a randomized controlled trial. J Psychosom Res. 2009;67(1):17–23.CrossRefPubMed Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Further development of an illness perception intervention for myocardial infarction patients: a randomized controlled trial. J Psychosom Res. 2009;67(1):17–23.CrossRefPubMed
20.
go back to reference Lynggaard V, May O, Beauchamp A, Nielsen CV, Wittrup I. LC-REHAB: randomised trial assessing the effect of a new patient education method--learning and coping strategies--in cardiac rehabilitation. BMC Cardiovasc Disord. 2014;14(1):186.CrossRefPubMedPubMedCentral Lynggaard V, May O, Beauchamp A, Nielsen CV, Wittrup I. LC-REHAB: randomised trial assessing the effect of a new patient education method--learning and coping strategies--in cardiac rehabilitation. BMC Cardiovasc Disord. 2014;14(1):186.CrossRefPubMedPubMedCentral
21.
go back to reference Lynggaard V, Nielsen CV, Zwisler A, Taylor RS, May O. The patient education - learning and coping strategies - improves adherence in cardiac rehabilitation (LC-REHAB): a randomised controlled trial. Int J Cardiol. 2017;1;236:65-70. Lynggaard V, Nielsen CV, Zwisler A, Taylor RS, May O. The patient education - learning and coping strategies - improves adherence in cardiac rehabilitation (LC-REHAB): a randomised controlled trial. Int J Cardiol. 2017;1;236:65-70.
22.
go back to reference Boutron I, Altman DG, Moher D, Schulz KF, Ravaud P, CONSORT NPT Group. CONSORT statement for randomized trials of nonpharmacologic treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Ann Intern Med. 2017;167(1):40–7.CrossRefPubMed Boutron I, Altman DG, Moher D, Schulz KF, Ravaud P, CONSORT NPT Group. CONSORT statement for randomized trials of nonpharmacologic treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Ann Intern Med. 2017;167(1):40–7.CrossRefPubMed
23.
go back to reference The Danish Health Authority 2015. National Clinical Guideline for Cardiac Rehabilitation. 2015; Available at: www.sst.dk. Accessed 24 Aug 2017. The Danish Health Authority 2015. National Clinical Guideline for Cardiac Rehabilitation. 2015; Available at: www.​sst.​dk. Accessed 24 Aug 2017.
25.
go back to reference Hjollund NH, Larsen FB, Andersen JH. Register-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health. 2007;35(5):497–502.CrossRefPubMed Hjollund NH, Larsen FB, Andersen JH. Register-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health. 2007;35(5):497–502.CrossRefPubMed
26.
go back to reference Bech P, Rasmussen N, Olsen LR, Noerholm V, Abildgaard W. The sensitivity and specificity of the major depression inventory, using the present state examination as the index of diagnostic validity. J Affect Disord. 2001;66(2):159–64.CrossRefPubMed Bech P, Rasmussen N, Olsen LR, Noerholm V, Abildgaard W. The sensitivity and specificity of the major depression inventory, using the present state examination as the index of diagnostic validity. J Affect Disord. 2001;66(2):159–64.CrossRefPubMed
28.
go back to reference de Boer AG, Taskila TK, Tamminga SJ, Feuerstein M, Frings-Dresen MHW, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2015;9:CD007569. de Boer AG, Taskila TK, Tamminga SJ, Feuerstein M, Frings-Dresen MHW, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2015;9:CD007569.
29.
go back to reference Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 2008;337(7676):979–83. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 2008;337(7676):979–83.
30.
go back to reference WHO. ICF: international classification of functioning, disability and health. Geneva: WHO; 2001. WHO. ICF: international classification of functioning, disability and health. Geneva: WHO; 2001.
32.
go back to reference Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, Hof A, Meindersma EP, et al. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol. 2016;223:436–43.CrossRefPubMed Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, Hof A, Meindersma EP, et al. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol. 2016;223:436–43.CrossRefPubMed
33.
go back to reference WHO. Chapter 4 on rehabilitation. World report on disability. Geneva: World Health Organization; 2011. p. 325. WHO. Chapter 4 on rehabilitation. World report on disability. Geneva: World Health Organization; 2011. p. 325.
34.
go back to reference Stapelfeldt CM, Jensen C, Andersen NT, Fleten N, Nielsen CV. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality. BMC Public Health. 2012;12(1):661.CrossRefPubMedPubMedCentral Stapelfeldt CM, Jensen C, Andersen NT, Fleten N, Nielsen CV. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality. BMC Public Health. 2012;12(1):661.CrossRefPubMedPubMedCentral
35.
go back to reference Statistics Denmark. Education and knowledge. Statistical yearbook. 120th ed. Copenhagen: Statistics Denmark; 2016. p. 548. pages-136-153 Statistics Denmark. Education and knowledge. Statistical yearbook. 120th ed. Copenhagen: Statistics Denmark; 2016. p. 548. pages-136-153
36.
go back to reference World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
37.
go back to reference Central Denmark Region. Disease management program for cardiovascular diseases, focus on cardiac rehabilitation after myocardial infarction and severe angina. april ed. Viborg: Central Denmark Region; 2008. Central Denmark Region. Disease management program for cardiovascular diseases, focus on cardiac rehabilitation after myocardial infarction and severe angina. april ed. Viborg: Central Denmark Region; 2008.
38.
go back to reference Beauchamp A, Worcester M, Ng A, Murphy B, Tatoulis J, Grigg L, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart. 2013;99(9):620–5.CrossRefPubMed Beauchamp A, Worcester M, Ng A, Murphy B, Tatoulis J, Grigg L, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart. 2013;99(9):620–5.CrossRefPubMed
Metadata
Title
Effect of the patient education - Learning and Coping strategies - in cardiac rehabilitation on return to work at one year: a randomised controlled trial show (LC-REHAB)
Authors
Birgitte Laier Bitsch
Claus Vinther Nielsen
Christina Malmose Stapelfeldt
Vibeke Lynggaard
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2018
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-018-0832-2

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