Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology.

Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation.

Home-Based Cardiac Rehabilitation: A SCIENTIFIC STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION, THE AMERICAN HEART ASSOCIATION, AND THE AMERICAN COLLEGE OF CARDIOLOGY.

Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation.

Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology.

Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation.

Assessing Physical Activity as a Core Component in Cardiac Rehabilitation: A POSITION STATEMENT OF THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

Physical inactivity is a well-established major risk factor for cardiovascular disease. As such, physical activity counseling is 1 of the 10 core components of cardiac rehabilitation/secondary prevention programs recommended by the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). In addition, the ability to perform a physical activity assessment and report outcomes is 1 of the 10 core competencies of cardiac rehabilitation/secondary prevention professionals published by the AACVPR.

Heart Failure as a Newly Approved Diagnosis for Cardiac Rehabilitation: Challenges and Opportunities.

Many see the broadened eligibility of cardiac rehabilitation (CR) to include heart failure with reduced ejection fraction (HFrEF) as a likely catalyst to high CR enrollment and improved care. However, such expectation contrasts with the reality that CR enrollment of eligible coronary heart disease patients has remained low for decades. In this review, entrenched obstacles impeding utilization of CR are considered, particularly in relation to potential HFrEF management.

Support for diabetes using technology: a pilot study to improve self-management.

Technology may assist people living with type 2 diabetes with self-management. A pilot study that used Apple iPad technology to support diabetes self-management is described.

A program to provide resources and support for clinical associates.

Clinical associates are necessary and valued contributors to nursing education. All those involved in student instruction need to have clearly defined expectations that are aligned with the conceptual framework and program outcomes. Additionally, they must have the necessary resources to facilitate their ability to effectively instruct and evaluate nursing students in the clinical setting.

International Charter on Cardiovascular Prevention and Rehabilitation: a call for action.

Cardiovascular disease remains the leading cause of death in both women and men globally and is a growing epidemic in low- to middle-income countries. Without systematic access to cardiac rehabilitation (CR), these individuals may experience multiple recurrent acute care events and suffer unnecessarily premature death. The 2 aims of this Charter are (1) to bring together national associations from around the world to harmonize efforts in promoting cardiovascular prevention and rehabilitation and (2) to document consensus among national associations globally, regarding the internationally common core elements and benefits of cardiovascular disease prevention and rehabilitation.

Writing for publication: faculty development initiative using social learning theory.

Demonstrating scholarly competency is an expectation for nurse faculty. However, there is hesitancy among some faculty to fully engage in scholarly activities. To strengthen a school of nursing's culture of scholarship, a faculty development writing initiative based on Social Learning Theory was implemented.

Cardiac rehabilitation outcomes: impact of comorbidities and age.

Purpose: Medical comorbidities (CM) contribute to cardiac rehabilitation (CR) underutilization. Whether individuals with coronary heart disease and an increased CM burden achieve similar benefits from CR as those with a low CM burden is unknown.

Methods: We analyzed 794 patients with coronary heart disease completing CR from 1/96 to 4/08.

Clinical research in cardiac rehabilitation and secondary prevention: looking back and moving forward.

Cardiac rehabilitation/secondary prevention (CR/SP) programs are considered standard of care and provide critically important resources for optimizing the care of cardiac patients. The objective of this article is to briefly review the evolution of CR/SP programs from a singular exercise intervention to its current, more comprehensive multifaceted approach. In addition, we offer perspective on critical concerns and suggest future research considerations to optimize the effectiveness and utilization of CR/SP program interventions.

Core competencies for cardiac rehabilitation/secondary prevention professionals: 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation.

Cardiac rehabilitation/secondary prevention (CR/SP) services are typically delivered by a multidisciplinary team of health care professionals. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that to provide high-quality services, it is important for these health care professionals to possess certain core competencies. This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency.

Exercise as a treatment for the risk of cardiovascular disease.

Regular physical activity decreases the risk of cardiovascular disease and modifies multiple cardiovascular risk factors. The optimum amount of exercise continues to generate debate; however, the general recommendation is that all adults should engage in 30 min of moderate-intensity physical activity on five, and preferably all, days of the week. Despite extensive data and recommendations, a significant proportion of the US adult population remains sedentary.

Cardiac rehabilitation and women: what keeps them away?

Background: Cardiac rehabilitation (CR) is underutilized, especially among women. The goal of this study was to examine CR referral and enrollment patterns among eligible women and identify factors associated with utilization.

Methods: The sample included women (n = 131) hospitalized with an eligible CR diagnosis between April 2001 and August 2002.

Assessing patient recall of discharge instructions for acute myocardial infarction.

Guidelines for acute myocardial infarction (AMI) include secondary prevention (SP) strategies, but little is known about patients' recall of instructions following hospital discharge. We conducted telephone interviews to assess recall of risk-reduction information among patients discharged with AMI. Results indicated similar proportions of documented and patient recall of discharge instructions.

Comparison of baseline characteristics and outcomes in younger and older patients completing cardiac rehabilitation.

Purpose: Cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) remains underutilized especially among older patients. The present study compares baseline characteristics and CR outcomes between younger and older patients participating in CR.

Methods: Comparisons were made between "younger" (<65 years) and "older" patients (> or = 65 years) for baseline characteristics, changes in selected measures during CR, and the proportion of patients at secondary prevention treatment goals before and after CR.

Drugs are not enough: the metabolic syndrome--a call for intensive therapeutic lifestyle change.

Whether intensive pharmacologic cardiovascular risk factor management reduces metabolic syndrome (MetS) prevalence is unknown. The authors compared the number of secondary prevention medications and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)-defined MetS prevalence in coronary artery disease patients entering cardiac rehabilitation from 1996 to 2001 (period 1, n=516) with those entering from 2002 to 2006 (period 2, n=609). Age, sex, and ethnicity were similar in both periods.

Influenza vaccination in secondary prevention: an opportunity missed.

Purpose: Influenza vaccination (FluVacc) has been added as a class I recommendation in the 2006 American Heart Association/American College of Cardiology Secondary Prevention Guidelines. Little is known about prevalence and correlates of FluVacc among patients with coronary heart disease enrolled in cardiac rehabilitation.

Methods: Data from patients with coronary heart disease enrolled in an academic medical center cardiac rehabilitation program from January 1996 through March 2006 (n = 1,051) were analyzed.

Secondary prevention outcomes among black and white cardiac rehabilitation patients.

Background: Disparities in coronary heart disease and related risk factors persist. It is unknown if cardiac rehabilitation (CR) narrows the gap in risk factor control between black and white patients. Thus, we compared baseline characteristics and secondary prevention outcomes between black and white CR patients.

Outcomes at one-year follow-up of women and men with coronary artery disease discharged from cardiac rehabilitation: what benefits are maintained?

Introduction: Little is known about which benefits achieved during cardiac rehabilitation (CR) are maintained 1 year after CR discharge and whether there are any gender-specific differences.

Methods: One-year follow-up data were available in 244/533 (46%; mean age 62 +/- 11 years, 30% women, 30% nonwhite) patients with coronary artery disease discharged from CR between 1996 and 2005. We compared changes in clinical, behavioral, and health status variables from baseline to CR completion, CR completion to 1-year follow-up, and baseline to 1-year follow-up for the group overall and separately for men and women.

Women in cardiac rehabilitation: outcomes and identifying risk for dropout.

Background: Women are underrepresented in cardiac rehabilitation (CR). Few reports describe outcomes and explore factors that may be barriers to CR participation among women. The purposes of this study were to (1) compare baseline characteristics between women who completed and did not complete CR, (2) identify factors associated with women completing CR, and (3) describe outcomes among completers.

AACVPR consensus statement. Outcomes evaluation in cardiac rehabilitation/secondary prevention programs: improving patient care and program effectiveness.

The reported outcomes statement is an update to the previous recommendations for outcomes evaluation in cardiac rehabilitation/secondary prevention programs. The purposes of outcomes evaluation are reviewed, and practical information with examples is provided to help programs implement an outcomes-directed approach within routine patient care and program management functions.