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Rachel Soon, 21 Feb 2018

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Multidisciplinary cardiac rehab programme improves CHD risk factors, patient's knowledge

Pearl Toh
30 Oct 2017

A multidisciplinary inpatient cardiac rehabilitation programme (CRP) helps reduce risk factors for coronary heart disease (CHD) and improves proper prescription of evidence-based medication as well as patient's knowledge about the disease, according to a study presented at SPCRS 2017.

Noting that CRP is constantly underutilized despite its well-established benefits, a multidisciplinary CRP involving a joint collaboration between the Department of Anaesthesia and Intensive Care, Department of Medicine and Geriatrics, and Department of Physiotherapy was implemented in Cardiac Care Unit (CCU) of Pok Oi Hospital in Hong Kong. 

The study included 310 patients (mean age 60.4 years,85.5 percent males, 75.5 percent had ACS*, 94.5 percent had PCI**) admitted to CCU with CHD after stabilization. Risk factors for CHD were identified by attending cardiologists followed by education programme about CHD and control of risk factors offered by nurses, during which the patient's knowledge on CHD was assessed before and after attending CRP using a standardize questionnaire. Selected patients who had undergone revascularization were referred to physiotherapist to facilitate early mobilization. Blood test was performed at admission and during follow-up at outpatient clinics.  

After a mean follow-up of 59 days, significant improvements from baseline were seen in various risk factors as assessed through blood sampling, including total cholesterol (C), LDL-C, HDL-C, and triglyceride (p<0.001 for all, except triglyceride, p=0.001). Fasting glucose (-12.5 percent; p<0.001) and HbA1c (-3.8 percent; p=0.018) were also significantly improved compared with baseline. [SPCRS 2017, abstract N-37]  

In addition, patient's knowledge improved by 14.3 percent after CRP, as indicated by increase in their questionnaire scores (12.14 vs 13.8; p<0.001). 

Compared with prescription at study recruitment, there was significant improvement in the percentage of prescription of evidence-based medications on discharge, including ACEIs*** (51.6 percent vs 71.3 percent), beta-blockers (51.0 percent vs 65.8 percent), and statins (97.7 percent vs 98.7 percent; all p<0.001).

“The multidisciplinary inpatient CRP was effective in reducing risk factors, prescription percentage of evidence-based medication and enhanced patient's knowledge,” concluded the authors.   

 

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Pearl Toh, 30 Jan 2018
Use of statins may not be neuroprotective, in contrast to findings from previous observational studies. On the contrary, fungus-derived or lipophilic statins appeared to be associated with a slightly increased risk of Alzheimer's disease (AD) compared with synthetic and hydrophilic statins, suggests a new study based on real-world clinical practice data.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Rachel Soon, 21 Feb 2018

MIMS Pharmacist sits down with pharmacist researcher Dr Mai Chun Wai to find out more about his work in drug discovery, including his investigations of Antarctic soil microorganisms.