Key result
Adding 'Learning and Coping' strategies to cardiac rehabilitation provided inconsistent short-term results but improved SF-12 'role physical' score (difference 4.6; 95% CI 0.1-9.0) at 3 years.
Why the study?
The short- and long-term effects of the Learning and Coping patient education strategy in cardiac rehabilitation on quality of life, patient education impact, risk factors, and lifestyle were unknown.
Does the 'Learning and Coping' patient education strategy improve health-related quality of life and cardiac risk factors in patients hospitalized with ischaemic heart disease or heart failure undergoing cardiac rehabilitation?
RCT (n=825)
randomized
Yes
Does the 'Learning and Coping' patient education strategy improve health-related quality of life and cardiac risk factors in patients hospitalized with ischaemic heart disease or heart failure undergoing cardiac rehabilitation?
Adding a 'Learning and Coping' education strategy to cardiac rehabilitation yields inconsistent short-term benefits but may improve long-term physical role functioning.
May support long-term physical role gains in cardiac rehab; extends psychosocial intervention evidence beyond short-term assessments.
The objectives were to assess the short- and long-term effect of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on health-related quality of life, patient education impact, cardiac risk factors and lifestyle. In total, 825 patients hospitalized with ischaemic heart disease or heart failure were randomized to either LC-CR or standard CR at three Danish hospitals. Teaching approach in LC-CR was situational, inductive and reflective, with experienced patients as co-educators and supplemental interviews. Teaching approach in standard CR was structured and deductive. Outcomes were assessed immediately after CR, and after 3 months (short term), and after 3 years (long term). Between-arm differences in favour of LC-CR were SF-12 'role emotional' (3.7, 95% CI: 0.6-6.8) and MDI depression score (0.9, 0.1-1.8) immediately after CR, exercise capacity (4 W, 1-9) at 3 months and SF-12 'role physical' (4.6, 0.1-9.0) (long term). Between-arm differences in favour of controls were waist circumference (-1.7 cm, -2.3 to -1.0) immediately after CR and HeiQ domain 'Constructive attitudes and approaches' (0.11, 0.04-0.18), triglycerides (-0.12 mmol/l, -0.21 to -0.02), systolic blood pressure (-3.12 mmHg, -5.66 to -0.58) at 3 months. Adding LC strategies to CR provides inconsistent short-term results but improves 'role physical' long term.
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Lynggaard et al. (2020) conducted an RCT in ischaemic heart disease or heart failure (n=825). Learning and Coping (LC) strategy in cardiac rehabilitation vs. Standard cardiac rehabilitation was evaluated on Health-related quality of life, patient education impact, cardiac risk factors and lifestyle. Adding 'Learning and Coping' strategies to cardiac rehabilitation provided inconsistent short-term results but improved SF-12 'role physical' score (difference 4.6; 95% CI 0.1-9.0) at 3 years.
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