CARRISMA: a new tool to improve risk stratification and guidance of patients in cardiovascular risk management in primary prevention.

Aims: Risk stratification is important for decisions about the intensity of treatment in primary prevention. Risk factors and lifestyle factors are responsible for over 80% of cardiovascular morbidity and mortality. However, body mass index (BMI), physical activity and smoking (cigarettes/day) are not or not quantitatively represented in the risk stratification system.

Cardiac rehabilitation in Germany.

The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers.

[Heart groups in Germany-current situation and prospects].

Currently, more than 6,600 heart groups (AHGs) have been established in Germany, in which more than 110,000 patients are physically active. Following cardiac rehabilitation (CR) after an acute event, in the AHG patients aim to meet the set rehabilitation goals in groups of about 15-20 patients, instructed by a competent exercise therapist and attended by a physician. While physical activity has been the dominant aspect thus far, psychosocial and educative elements are now more strongly integrated to stabilize secondary prevention.

[Indicators of process and outcome quality in the context of multicenter quality management in cardiac rehabilitation].

From the point of view of quality management in general and clinic comparisons in particular, indicators of outcome quality must be chosen in such a way that conclusions regarding the quality of rehabilitational care processes can be drawn. Moreover, these indicators should reflect disease characteristics which, on the one hand, are relevant in terms of prognoses and, on the other, provide indications for rehabilitation therapy. Predictors of rehabilitation success need to be differentiated analytically in order to safeguard the adjustment of risks when, for instance, clinics are being compared.