Key result
Adding Learning and Coping to standard cardiac rehab fails to reduce 30-day readmissions.
Why the study?
The effects of the patient education strategy Learning and Coping in cardiac rehabilitation on mortality and readmissions were unknown.
Does the patient education strategy 'Learning and Coping' in cardiac rehabilitation reduce mortality and readmissions in patients with ischaemic heart disease or heart failure?
RCT (n=825)
randomized
Yes
Does the patient education strategy 'Learning and Coping' in cardiac rehabilitation reduce mortality and readmissions in patients with ischaemic heart disease or heart failure?
Adding the 'Learning and Coping' education strategy to standard cardiac rehabilitation did not significantly reduce long-term mortality or readmissions, though a non-significant short-term trend toward reduced readmissions was observed.
Answers are grounded in this paper and cite their sources.
Does not support adding 'Learning and Coping' education to cardiac rehabilitation to cut readmissions; leaves open whether refined strategies could prove effective.
We assessed the effects of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on mortality and readmissions by exploring results from the LC-REHAB trial. In all, 825 patients with ischaemic heart disease or heart failure were randomized to the intervention arm (LC-CR) or the control arm (standard CR) at three hospitals in Denmark. LC-CR was situational and inductive, with experienced patients as co-educators supplemented with two individual interviews. Group-based training and education hours were the same in both arms. Outcomes were time to death or readmission, length of stay and absolute number of deaths or readmissions. No between-arm differences were found in time to death, first readmission, or length of stay. Within 30 days after completion of CR, the absolute number of all-cause readmissions was 117 in the LC arm and 146 in the control arm, adjusted odds ratio 78 (95% CI: 0.61-1.01), P = 0.06. This trend diminished over time. Adding LC strategies to standard CR showed a short term but no significant long-term effect on mortality or readmissions. However, the study was not powered to detect differences in mortality and morbidity. Thus, a risk of overseeing a true effect was present.
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Lynggaard et al. (2019) conducted an RCT in ischaemic heart disease or heart failure (n=825). Learning and Coping (LC) patient education strategy vs. standard cardiac rehabilitation was evaluated on all-cause readmissions within 30 days after completion of cardiac rehabilitation (OR 0.78, 95% CI 0.61-1.01, p=0.06). Adding the 'Learning and Coping' education strategy to standard cardiac rehabilitation did not significantly reduce 30-day all-cause readmissions compared to standard care (OR 0.78; 95% CI 0.61-1.01; P=0.06).
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