The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial
Abstract Background Adherence and completion of programmes in educational and physical exercise sessions is essential in cardiac rehabilitation (CR) to obtain the known benefits on morbidity, mortality, risk factors, lifestyle, and quality of life. The patient education strategy “Learning and Coping...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02774-8 |
| _version_ | 1811320816926720000 |
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| author | Charlotte Gjørup Pedersen Claus Vinther Nielsen Vibeke Lynggaard Ann Dorthe Zwisler Thomas Maribo |
| author_facet | Charlotte Gjørup Pedersen Claus Vinther Nielsen Vibeke Lynggaard Ann Dorthe Zwisler Thomas Maribo |
| author_sort | Charlotte Gjørup Pedersen |
| collection | DOAJ |
| description | Abstract Background Adherence and completion of programmes in educational and physical exercise sessions is essential in cardiac rehabilitation (CR) to obtain the known benefits on morbidity, mortality, risk factors, lifestyle, and quality of life. The patient education strategy “Learning and Coping” (LC) has been reported to positively impact adherence and completion in a hospital setting. It is unknown if LC has impact on adherence in primary healthcare settings, and whether LC improves self-management. The aim of this pragmatic primary healthcare-based study was to examine whether patients attending CR based on LC had a better adherence to patient education and physical exercise, higher program completion rate, and better self-management compared to patients attending CR based on a consultation program Empowerment, Motivation and Medical Adherence (EMMA). Method A pragmatic cluster-controlled trial of two types of patient education LC and EMMA including ten primary healthcare settings and 514 patients (LC, n = 266; EMMA, n = 248) diagnosed with ischaemic heart disease discharged from hospital and referred to CR between August 1, 2018 and July 31, 2019. Adherence was defined as participation in ≥ 75% of provided sessions. Completion was defined as patients attended the final interview at the end of the 12-weeks programme. Patient Activation Measure (PAM) was used to obtain information on a person's knowledge, skills and confidence for self-management. PAM questionnaire was completed at baseline and 12-weeks follow-up. Multiple and Linear regression analyses adjusted for potential confounder variables and cluster effect were performed. Result Patients who followed CR based on LC had a higher adherence rate to educational and physical exercise sessions compared to patients who followed CR based on EMMA (p < 0.01). High-level of completion was found at the end of CR with no statistically significant between clusters (78.9% vs. 78.2%, p > 0.05). At 12-weeks, there was no statistical differences in PAM-score between clusters (p > 0.05). Conclusion This study indicates that the LC positively impacts adherence in CR compared to EMMA. We found non-significant difference in completing CR and in patient self-management between the two types of patient education. Future studies are needed to investigate if the higher adherence rate achieved by LC in primary healthcare settings translates into better health outcomes. |
| first_indexed | 2024-04-13T13:06:08Z |
| format | Article |
| id | doaj.art-5955854e65414468ac8f13e6b8ecbd87 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-13T13:06:08Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-5955854e65414468ac8f13e6b8ecbd872022-12-22T02:45:46ZengBMCBMC Cardiovascular Disorders1471-22612022-08-0122111010.1186/s12872-022-02774-8The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trialCharlotte Gjørup Pedersen0Claus Vinther Nielsen1Vibeke Lynggaard2Ann Dorthe Zwisler3Thomas Maribo4Department of Public Health, Aarhus UniversityDepartment of Public Health, Aarhus UniversityCardiovascular Research Unit, Department of Cardiology, Gødstrup HospitalREHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University HospitalDepartment of Public Health, Aarhus UniversityAbstract Background Adherence and completion of programmes in educational and physical exercise sessions is essential in cardiac rehabilitation (CR) to obtain the known benefits on morbidity, mortality, risk factors, lifestyle, and quality of life. The patient education strategy “Learning and Coping” (LC) has been reported to positively impact adherence and completion in a hospital setting. It is unknown if LC has impact on adherence in primary healthcare settings, and whether LC improves self-management. The aim of this pragmatic primary healthcare-based study was to examine whether patients attending CR based on LC had a better adherence to patient education and physical exercise, higher program completion rate, and better self-management compared to patients attending CR based on a consultation program Empowerment, Motivation and Medical Adherence (EMMA). Method A pragmatic cluster-controlled trial of two types of patient education LC and EMMA including ten primary healthcare settings and 514 patients (LC, n = 266; EMMA, n = 248) diagnosed with ischaemic heart disease discharged from hospital and referred to CR between August 1, 2018 and July 31, 2019. Adherence was defined as participation in ≥ 75% of provided sessions. Completion was defined as patients attended the final interview at the end of the 12-weeks programme. Patient Activation Measure (PAM) was used to obtain information on a person's knowledge, skills and confidence for self-management. PAM questionnaire was completed at baseline and 12-weeks follow-up. Multiple and Linear regression analyses adjusted for potential confounder variables and cluster effect were performed. Result Patients who followed CR based on LC had a higher adherence rate to educational and physical exercise sessions compared to patients who followed CR based on EMMA (p < 0.01). High-level of completion was found at the end of CR with no statistically significant between clusters (78.9% vs. 78.2%, p > 0.05). At 12-weeks, there was no statistical differences in PAM-score between clusters (p > 0.05). Conclusion This study indicates that the LC positively impacts adherence in CR compared to EMMA. We found non-significant difference in completing CR and in patient self-management between the two types of patient education. Future studies are needed to investigate if the higher adherence rate achieved by LC in primary healthcare settings translates into better health outcomes.https://doi.org/10.1186/s12872-022-02774-8Cardiac rehabilitationPrimary healthcare settingsPatient education strategyAdherenceCompletionSelf-management |
| spellingShingle | Charlotte Gjørup Pedersen Claus Vinther Nielsen Vibeke Lynggaard Ann Dorthe Zwisler Thomas Maribo The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial BMC Cardiovascular Disorders Cardiac rehabilitation Primary healthcare settings Patient education strategy Adherence Completion Self-management |
| title | The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial |
| title_full | The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial |
| title_fullStr | The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial |
| title_full_unstemmed | The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial |
| title_short | The patient education strategy “learning and coping” improves adherence to cardiac rehabilitation in primary healthcare settings: a pragmatic cluster-controlled trial |
| title_sort | patient education strategy learning and coping improves adherence to cardiac rehabilitation in primary healthcare settings a pragmatic cluster controlled trial |
| topic | Cardiac rehabilitation Primary healthcare settings Patient education strategy Adherence Completion Self-management |
| url | https://doi.org/10.1186/s12872-022-02774-8 |
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