Rationale:
Cardiac rehabilitation reduces event and procedure recurrence, related costs, and overdependence on the health care system.
Objective:
To determine the effects of multifactorial Phase II transitional cardiac rehabilitation on the metabolic syndrome, related clinical variables, and the economic domain.
Methods:
Eighty-two [82] patients [53 men, 29 women (35%)], including 52 [63%] having comorbid diabetes mellitus, mean age 64.5 +/- 8.9 years served as subjects. They were enrolled in a multifactorial Cardiac Rehabilitation Program [CRP]. Interventions included an exercise program, smoke cessation, nutritional counseling, and educational sessions. Guest speakers were physicians, nurses, exercise physiologists, podiatrists, registered dietitians, pharmacists, physical therapists, and other health professionals. Social events and fun competition events were also scheduled to enhance group camaraderie. Patients were risk stratified with a profile that included their history, physical, exercise test, pulmonary function test, lipid profile, CBC, hemoglobin A1c, anthropometric measures, and risk factors. Selected measures were repeated at 12 weeks.
Results:
Significant changes in the metabolic syndrome were observed for waist girth [P <.02], serum triglyceride [P < .01], and fasting blood glucose [P < .01]. Significant improvement was also seen [P < .01] for the following: hemoglobin A1c, total serum cholesterol [TSC], low density lipoprotein cholesterol [LDL-C], very low density lipoprotein cholesterol [VLDL-C], NONHDL, TSC/HDL, and LDL/HDL. In the Behavioral Domain, significant progress was made with Exercise Compliance [P < .001], Dietary Compliance [P < .001], Medication Compliance [P < .02], and Beck Depression Inventory score [P < 0.001]. Economic Domain variables improving significantly [P < .01] were Medications, ER Visits, Hospital Admissions, and Physician Visits.
Conclusion:
Participation in a multifactorial CRP had a significant impact on the Economic Domain that is reflected in reduced dependence on the healthcare system. This includes significant reductions in:
* Medication requirements
* Emergency room visits
* Hospital admissions
* Visits to the physician