Author details
Author Ilse Van Vlaenderen |
Available item(s) by this author (6)
Add the result to your basket Make a suggestion Refine your search Apply to external sourcesCardiac rehabilitation / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)
ISSN : D/2010/10.273/67 : € 0,00
Study n. : 2009-22
Languages : English (eng)
Descriptors: Indexation
2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers
Classification
WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- TherapeuticsContents note: GLOSSARY 3 -- 1 BACKGROUND AND RESEARCH QUESTIONS 4 -- 1.1 BACKGROUND 4 -- 1.1.1 Cardiac rehabilitation 4 -- 1.1.2 Different approaches to cardiac rehabilitation 4 -- 1.1.3 Heart disease and treatment goals 4 -- 1.1.4 Organisation of multidisciplinary cardiac rehabilitation in Belgium 5 -- 1.1.5 Treatment access 5 -- 1.2 RESEARCH QUESTIONS 6 -- 1.3 PARTS OF THE STUDY 6 -- 2 SYSTEMATIC LITERATURE REVIEW 7 -- 2.1 RESEARCH QUESTION 7 -- 2.2 METHODS 7 -- 2.2.1 Selection of studies 7 -- 2.2.2 Project Outline 8 -- 2.2.3 Literature search strategy 9 -- 2.2.4 Assessing methodological quality and risk of bias 9 -- 2.2.5 Data extraction 10 -- 2.3 RESULTS 10 -- 2.3.1 Phase I: systematic reviews and meta-analyses 10 -- 2.3.2 Phase II: original RCTs 17 -- 2.3.3 Multidisciplinary cardiac rehabilitation versus exercise 22 -- 2.4 HTA DOCUMENTS 22 -- 2.5 SUMMARY OF RESULTS AND DISCUSSION 24 -- 2.5.1 Summary of results 24 -- 2.5.2 Additional Cochrane reviews published in 2010 25 -- 2.5.3 Discussion of results 26 -- 2.5.4 Systematic review of the economic literature 27 -- 2.5.5 Comparison of the current results with guidance documents 28 -- 3 REHABILITATION AFTER DEFINED CARDIAC PROCEDURES IN BELGIUM: -- DATA ANALYSIS 32 -- 3.1 METHODOLOGY 32 -- 3.1.1 Data source 32 -- 3.1.2 Study period and observation period 32 -- 3.1.3 Target population and patient selection procedure 33 -- 3.1.4 Data collection 34 -- 3.1.5 Patient classification 35 -- 3.1.6 Data analysis 38 -- 3.2 RESULTS 39 -- 3.2.1 Patients selected for analysis. 39 -- 3.2.2 Patient Geographical Spread 40 -- 3.2.3 Type of Rehabilitation 41 -- 3.2.4 Rehabilitation related data 45 -- 3.2.5 Utilisation of rehabilitation types per socio-demographic patient characteristics 53 -- 3.2.6 Cardiac centre related data 60 -- 3.2.7 Multivariate analysis 61 -- 3.2.8 Cardiac disease related resource use: outpatient visits and diagnostic tests 65 -- 3.3 SUMMARY AND LIMITATIONS 69 -- 3.3.1 Summary of the descriptive statistics 69 -- 3.3.2 Summary of the multivariate analyses 70 -- 3.3.3 Strengths and limitations of the data analysis 70 -- 4 PATIENT SURVEY 71 -- 4.1 METHODOLOGY 71 -- 4.1.1 Study design 71 -- 4.1.2 Study population 71 -- 4.1.3 Time horizon 71 -- 4.1.4 Patient recruitment 72 -- 4.1.5 Data management & privacy 72 -- 4.1.6 Data collection 72 -- 4.1.7 Data analysis 73 -- 4.2 RESULTS 74 -- 4.2.1 Cardiologists 74 -- 4.2.2 Characteristics of the patients. 74 -- 4.2.3 Participation to the cardiac rehabilitation programme 75 -- 4.3 SUMMARY OF RESULTS AND LIMITATIONS OF THE SURVEY 86 -- 4.3.1 Main results 86 -- 4.3.2 Limitations of the survey 87 -- 5 GENERAL DISCUSSION AND CONCLUSIONS 88 -- 5.1 DEFINITIONS OF MULTIDISCIPLINARY REHABILITATION 88 -- 5.2 EVIDENCE ABOUT EXERCISE AND MULTIDISCIPLINARY CARDIAC REHABILITATION -- INCLUDING EXERCISE 88 -- 5.3 LACK OF PRECISION ABOUT TARGET POPULATIONS AND OTHER FEATURES OF -- CARDIAC REHABILITATION 89 -- 5.4 PARTICIPATION IN REHABILITATION PROGRAMMES IN BELGIUM 89 -- 5.4.1 Influence of patient characteristics 89 -- 5.4.2 Other factors that influence the participation in cardiac rehabilitation programmes 91 -- 5.4.3 Limits in the comparison between this study and the data from the literature 91 -- 6 REFERENCES 93 Link for e-copy: https://doi.org/10.57598/R140C Format of e-copy: PDF (2,43 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2217 Copies(0)
Status No copy
ISSN : D/2010/10.273/68 : € 0,00
Study n. : 2009-22
Languages : English (eng)
Descriptors: Indexation
2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers
Classification
WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- TherapeuticsContents note: GLOSSARY 2 -- 1 APPENDICES SYSTEMATIC LITERATURE REVIEW 3 -- Appendix 1: systematic review Search strategy 3 -- Appendix 2: RCT Search strategy 10 -- Appendix 3: INAHTA member websites searched 17 -- 2 APPENDICES: ANALYSIS OF IMA DATABASE 79 -- Appendix 1: Nomenclature codes used for patient classification 79 -- Appendix 2: Description of patient inclusion and exclusion 85 -- appendix 3: Rehabilitation sequences 86 -- Appendix 4 rehabilitation related data during the entire one-year observation period 87 -- Appendix 5: cost related to rehabilitation 91 -- Appendix 6 socio-demographic patient characteristics 98 -- Appendix 7 Geographical spread of patients in outpatient rehabilitation 99 -- Appendix 8 Cardiac disease related medical care consumption 103 -- Appendix 9: Multivariate analysis 107 -- 3 APPENDIX : SURVEY 109 -- Patient Survey questionnaires 109 -- List of participating hospitals/centres 117 -- Participating cardiologists 117 -- Details on patients’ characteristics 118 -- Details on the participation to the rehabilitation programme 121 Link for e-copy: https://doi.org/10.57598/R140S Format of e-copy: PDF (1,18 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2218 Copies(0)
Status No copy
ISSN : D/2010/10.273/65 : € 0,00
Studie nr : 2009-22
Languages : English (eng) Dutch (nla)
Descriptors: Indexation
2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers
Classification
WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- TherapeuticsAbstract: Hartrevalidatie met lichamelijke oefeningen heeft een gunstig effect op de levenskwaliteit van hartpatiënten en vermindert het aantal hospitalisaties en overlijdens. Dit is een belangrijke conclusie van een studie van het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) en Deloitte®. Toch volgt minder dan een op 2 hartpatiënten revalidatie na hospitalisatie. Vooral ouderen en vrouwen dreigen uit de boot te vallen. Als belangrijkste redenen vermelden ze tijdsgebrek, het idee dat ze ook wel zonder deze behandeling zullen genezen, de afstand tot een erkend revalidatiecentrum en het gebrek aan transportmiddelen. Het KCE pleit voor de ontwikkeling van individueel aangepaste oefen- en begeleidingsprogramma’s bij het ontslag uit het ziekenhuis, gespreid over verschillende maanden en dichtbij de woonplaats van de patiënt. Contents note: GLOSSARY 3 -- 1 BACKGROUND AND RESEARCH QUESTIONS 4 -- 1.1 BACKGROUND 4 -- 1.1.1 Cardiac rehabilitation 4 -- 1.1.2 Different approaches to cardiac rehabilitation 4 -- 1.1.3 Heart disease and treatment goals 4 -- 1.1.4 Organisation of multidisciplinary cardiac rehabilitation in Belgium 5 -- 1.1.5 Treatment access 5 -- 1.2 RESEARCH QUESTIONS 6 -- 1.3 PARTS OF THE STUDY 6 -- 2 SYSTEMATIC LITERATURE REVIEW 7 -- 2.1 RESEARCH QUESTION 7 -- 2.2 METHODS 7 -- 2.2.1 Selection of studies 7 -- 2.2.2 Project Outline 8 -- 2.2.3 Literature search strategy 9 -- 2.2.4 Assessing methodological quality and risk of bias 9 -- 2.2.5 Data extraction 10 -- 2.3 RESULTS 10 -- 2.3.1 Phase I: systematic reviews and meta-analyses 10 -- 2.3.2 Phase II: original RCTs 17 -- 2.3.3 Multidisciplinary cardiac rehabilitation versus exercise 22 -- 2.4 HTA DOCUMENTS 22 -- 2.5 SUMMARY OF RESULTS AND DISCUSSION 24 -- 2.5.1 Summary of results 24 -- 2.5.2 Additional Cochrane reviews published in 2010 25 -- 2.5.3 Discussion of results 26 -- 2.5.4 Systematic review of the economic literature 27 -- 2.5.5 Comparison of the current results with guidance documents 28 -- 3 REHABILITATION AFTER DEFINED CARDIAC PROCEDURES IN BELGIUM: -- DATA ANALYSIS 32 -- 3.1 METHODOLOGY 32 -- 3.1.1 Data source 32 -- 3.1.2 Study period and observation period 32 -- 3.1.3 Target population and patient selection procedure 33 -- 3.1.4 Data collection 34 -- 3.1.5 Patient classification 35 -- 3.1.6 Data analysis 38 -- 3.2 RESULTS 39 -- 3.2.1 Patients selected for analysis. 39 -- 3.2.2 Patient Geographical Spread 40 -- 3.2.3 Type of Rehabilitation 41 -- 3.2.4 Rehabilitation related data 45 -- 3.2.5 Utilisation of rehabilitation types per socio-demographic patient characteristics 53 -- 3.2.6 Cardiac centre related data 60 -- 3.2.7 Multivariate analysis 61 -- 3.2.8 Cardiac disease related resource use: outpatient visits and diagnostic tests 65 -- 3.3 SUMMARY AND LIMITATIONS 69 -- 3.3.1 Summary of the descriptive statistics 69 -- 3.3.2 Summary of the multivariate analyses 70 -- 3.3.3 Strengths and limitations of the data analysis 70 -- 4 PATIENT SURVEY 71 -- 4.1 METHODOLOGY 71 -- 4.1.1 Study design 71 -- 4.1.2 Study population 71 -- 4.1.3 Time horizon 71 -- 4.1.4 Patient recruitment 72 -- 4.1.5 Data management & privacy 72 -- 4.1.6 Data collection 72 -- 4.1.7 Data analysis 73 -- 4.2 RESULTS 74 -- 4.2.1 Cardiologists 74 -- 4.2.2 Characteristics of the patients. 74 -- 4.2.3 Participation to the cardiac rehabilitation programme 75 -- 4.3 SUMMARY OF RESULTS AND LIMITATIONS OF THE SURVEY 86 -- 4.3.1 Main results 86 -- 4.3.2 Limitations of the survey 87 -- 5 GENERAL DISCUSSION AND CONCLUSIONS 88 -- 5.1 DEFINITIONS OF MULTIDISCIPLINARY REHABILITATION 88 -- 5.2 EVIDENCE ABOUT EXERCISE AND MULTIDISCIPLINARY CARDIAC REHABILITATION -- INCLUDING EXERCISE 88 -- 5.3 LACK OF PRECISION ABOUT TARGET POPULATIONS AND OTHER FEATURES OF -- CARDIAC REHABILITATION 89 -- 5.4 PARTICIPATION IN REHABILITATION PROGRAMMES IN BELGIUM 89 -- 5.4.1 Influence of patient characteristics 89 -- 5.4.2 Other factors that influence the participation in cardiac rehabilitation programmes 91 -- 5.4.3 Limits in the comparison between this study and the data from the literature 91 -- 6 REFERENCES 93 Link for e-copy: https://doi.org/10.57598/R140A Format of e-copy: PDF (2,33 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2216 Copies(0)
Status No copy Multidisciplinary outpatient rehabilitation following cardiac revascularization or valve surgery / Danielle Strens in European Journal of Preventive Cardiology, 20(2013)03 ([06/01/2013])
Languages : English (eng)
in European Journal of Preventive Cardiology > 20(2013)03 [06/01/2013] . - 422-430
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
2009-22 ; Ambulatory Care ; Belgium ; Cardiac Surgical Procedures ; Delivery of Health Care, Integrated ; Disabled Persons ; Journal Article ; Patient Care ; Patient Care Team ; Peer Review ; R140 ; Risk FactorsAbstract: Background: There are concerns in Europe regarding the service provision and accessibility of multidisciplinary cardiac rehabilitation (MDCR) in general, and particularly in ambulatory settings. This paper analyses the utilization of outpatient MDCR and its determinants after cardiac revascularization or valve surgery in Belgium.
Methods: Claims rehabilitation data for all patients discharged in 2007 after a percutaneous cardiac intervention or cardiac surgery were available from the Belgian Common Sickness Funds Agency. Logistic regressions were performed to identify patients demographic and socioeconomic characteristics associated with the uptake of outpatient MDCR during the year following the hospital discharge.
Results: A total of 29,021 patients were included. During the hospitalization for the cardiac procedure, 44% were offered inpatient MDCR. After discharge, only 15.6% followed at least one session of outpatient MDCR. The chance of attending outpatient MDCR was lower for female, disabled, and older patients, as well as unemployed patients. The absence of an authorized MDCR centre in the neighbourhood of the patient’s residence decreased the chance of attending outpatient MDCR, while living in a neighbourhood with a high education and income level increased this probability.
Conclusion: These results confirm the low rates of MDCR attendance found in a previous study performed by the European Association of Cardiovascular Prevention and Rehabilitation. The study shows specific patient groups that should be targeted in priority, i.e. women, elderly, unemployed patients, disabled persons, and patients with a low socioeconomic status.Link for e-copy: http://doi.org/10.1177/2047487312441727 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3722 [article]
Languages : English (eng)
in European Journal of Preventive Cardiology > 20(2013)02 [04/01/2013] . - 341-348
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
2009-22 ; Aged ; Aged, 80 and over ; Belgium ; Cardiac Surgical Procedures ; Heart Diseases ; Journal Article ; Peer Review ; R140 ; Risk FactorsAbstract: Background: International research indicates that attendance of patients to a proposed cardiac rehabilitation (CR) programme varies between 21% and 75%. Addressing the reasons why cardiac patients are not participating will improve accessibility to CR. The objective of this study was to investigate patient compliance with cardiac rehabilitation and the reasons of refusing or abandoning the programme.
Methods: Twenty hospital centres were recruited to participate. Each centre was asked to recruit patients from three patient groups, namely: percutaneous coronary intervention patients, patients that underwent major cardiac surgery, and patients being admitted because of an acute myocardial infarction and not belonging to the other two groups. Patients were asked to fill out a questionnaire during a follow-up outpatient consultation after the cardiac intervention.
Results: In total, 226 patients participated in the survey. Most patients were proposed (86%) and accepted (81% out of proposed) to attend a CR programme. Of those who accepted, 77% completed the programme. The main reasons that led to patients’ refusal to participate in a CR programme were distance to the CR centre, patients’ belief they could handle their own problems, and lack of time. The main three reasons for not completing an initiated CR programme were other physical problems, patients’ belief they could handle their own problems, and the cost of rehabilitation.
Conclusion: Our findings demonstrate the importance of raising patients’ awareness of the benefits of CR. Addressing potential barriers to attend a CR programme should be investigated with patients individually in order to ensure compliance.Link for e-copy: http://doi.org/10.1177/2047487312437057 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3723 [article]
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