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The challenge of non-adherence to early rehabilitation after coronary artery bypass surgery: Secondary results from the SheppHeartCABG trial

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@article{53abbf40d8904043a79b252bffbec035,
title = "The challenge of non-adherence to early rehabilitation after coronary artery bypass surgery: Secondary results from the SheppHeartCABG trial",
abstract = "BACKGROUND: Attending and maintaining a cardiac rehabilitation programme is a challenge.AIMS: The purpose of this study was to explore associations between non-adherence to early coronary artery bypass graft rehabilitation and sociodemographic and clinical baseline data.METHODS: Coronary artery bypass graft patients were randomised 1:1 to either four weeks of comprehensive early rehabilitation or usual care. Outcomes were assessed at three time-points points: baseline, discharge and four weeks post-coronary artery bypass graft. Differences in sociodemographic and clinical baseline data in adherent versus non-adherent patients were tested using the Pearson χ2 test for categorical variables. To test associations between non-adherence to exercise training and sociodemographic and clinical baseline data, multivariate logistic regression was used to estimate the odds ratio for in-hospital training and post-discharge training adjusted for age, sex and left ventricular ejection fraction.RESULTS: Non-adherence to in-hospital versus post-discharge exercise training was 31{\%} (n=48) versus 53{\%} (n=81). Female non-adherence was 20{\%} versus 70{\%}. Non-adherence to in-hospital versus post-discharge mindfulness was 87{\%} versus 70{\%}. Male non-adherence to mindfulness was 85{\%} versus 70{\%}. Non-adherence to psycho-educational consultations was 3{\%}, most of whom were men. Patients with university level education were more adherent to in-hospital exercise training than patients with lower educational level (odds ratio=3.14 (95{\%} confidence interval; 1.16-8.51), p=0.02). Diabetic patients were more non-adherent to exercise training after discharge (3.74 (1.54-9.08), p=0.004) as were overweight patients (0.37 (0.17-0.80), p=0.01).CONCLUSIONS: This study demonstrated wide acceptance of psycho-educational consultations in post-coronary artery bypass graft patients. Adherence to physical rehabilitation was low especially after discharge from hospital and the opportunity to attend a mindfulness programme was not used.",
keywords = "Adherence, coronary artery bypass grafting, early rehabilitation, exercise psycho-education",
author = "H{\o}jskov, {Ida E} and Thygesen, {Lau C} and Philip Moons and Ingrid Egerod and Olsen, {Peter S} and Berg, {Selina K}",
year = "2020",
month = "3",
doi = "10.1177/1474515119883454",
language = "English",
volume = "19",
pages = "238--247",
journal = "European Journal of Cardiovascular Nursing",
issn = "1474-5151",
publisher = "Elsevier BV",
number = "3",

}

RIS

TY - JOUR

T1 - The challenge of non-adherence to early rehabilitation after coronary artery bypass surgery

T2 - Secondary results from the SheppHeartCABG trial

AU - Højskov, Ida E

AU - Thygesen, Lau C

AU - Moons, Philip

AU - Egerod, Ingrid

AU - Olsen, Peter S

AU - Berg, Selina K

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND: Attending and maintaining a cardiac rehabilitation programme is a challenge.AIMS: The purpose of this study was to explore associations between non-adherence to early coronary artery bypass graft rehabilitation and sociodemographic and clinical baseline data.METHODS: Coronary artery bypass graft patients were randomised 1:1 to either four weeks of comprehensive early rehabilitation or usual care. Outcomes were assessed at three time-points points: baseline, discharge and four weeks post-coronary artery bypass graft. Differences in sociodemographic and clinical baseline data in adherent versus non-adherent patients were tested using the Pearson χ2 test for categorical variables. To test associations between non-adherence to exercise training and sociodemographic and clinical baseline data, multivariate logistic regression was used to estimate the odds ratio for in-hospital training and post-discharge training adjusted for age, sex and left ventricular ejection fraction.RESULTS: Non-adherence to in-hospital versus post-discharge exercise training was 31% (n=48) versus 53% (n=81). Female non-adherence was 20% versus 70%. Non-adherence to in-hospital versus post-discharge mindfulness was 87% versus 70%. Male non-adherence to mindfulness was 85% versus 70%. Non-adherence to psycho-educational consultations was 3%, most of whom were men. Patients with university level education were more adherent to in-hospital exercise training than patients with lower educational level (odds ratio=3.14 (95% confidence interval; 1.16-8.51), p=0.02). Diabetic patients were more non-adherent to exercise training after discharge (3.74 (1.54-9.08), p=0.004) as were overweight patients (0.37 (0.17-0.80), p=0.01).CONCLUSIONS: This study demonstrated wide acceptance of psycho-educational consultations in post-coronary artery bypass graft patients. Adherence to physical rehabilitation was low especially after discharge from hospital and the opportunity to attend a mindfulness programme was not used.

AB - BACKGROUND: Attending and maintaining a cardiac rehabilitation programme is a challenge.AIMS: The purpose of this study was to explore associations between non-adherence to early coronary artery bypass graft rehabilitation and sociodemographic and clinical baseline data.METHODS: Coronary artery bypass graft patients were randomised 1:1 to either four weeks of comprehensive early rehabilitation or usual care. Outcomes were assessed at three time-points points: baseline, discharge and four weeks post-coronary artery bypass graft. Differences in sociodemographic and clinical baseline data in adherent versus non-adherent patients were tested using the Pearson χ2 test for categorical variables. To test associations between non-adherence to exercise training and sociodemographic and clinical baseline data, multivariate logistic regression was used to estimate the odds ratio for in-hospital training and post-discharge training adjusted for age, sex and left ventricular ejection fraction.RESULTS: Non-adherence to in-hospital versus post-discharge exercise training was 31% (n=48) versus 53% (n=81). Female non-adherence was 20% versus 70%. Non-adherence to in-hospital versus post-discharge mindfulness was 87% versus 70%. Male non-adherence to mindfulness was 85% versus 70%. Non-adherence to psycho-educational consultations was 3%, most of whom were men. Patients with university level education were more adherent to in-hospital exercise training than patients with lower educational level (odds ratio=3.14 (95% confidence interval; 1.16-8.51), p=0.02). Diabetic patients were more non-adherent to exercise training after discharge (3.74 (1.54-9.08), p=0.004) as were overweight patients (0.37 (0.17-0.80), p=0.01).CONCLUSIONS: This study demonstrated wide acceptance of psycho-educational consultations in post-coronary artery bypass graft patients. Adherence to physical rehabilitation was low especially after discharge from hospital and the opportunity to attend a mindfulness programme was not used.

KW - Adherence

KW - coronary artery bypass grafting

KW - early rehabilitation

KW - exercise psycho-education

U2 - 10.1177/1474515119883454

DO - 10.1177/1474515119883454

M3 - Journal article

VL - 19

SP - 238

EP - 247

JO - European Journal of Cardiovascular Nursing

JF - European Journal of Cardiovascular Nursing

SN - 1474-5151

IS - 3

ER -

ID: 59281502