Notes in Cardiac Rehabilitation LECTURE 38

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Published	01/07/2025	Definition of cardiac rehabilitation:The coordinated sum of activities required to influence favourably the underlying cause of {{c1::cardio…
Published	01/07/2025	Goals of Cardiac Rehabilitation:•Reduce the risk of adverse {{c1::cardiac}} events •D{{c1::eath}} •{{c1::MI}} •Re{{c1::hospitalisation}} •Improve card…
Published	01/07/2025	Benefits of Rehabilitation:•Reduced m{{c1::ortality}} •Reduced {{c1::adverse}} cardiac events (eg MI) •Reduced re-{{c1::hospitalisations}} •Higher smo…
Published	01/07/2025	Cause and effect•Observational data    •ie NOT prospective randomised studies •Patient self-selection    •? Fitter    •?…
Published	01/07/2025	•Target:    •{{c1::>40}}% reduction in non-HDL cholesterol (NICE) •Exercise training is associated with:    •Reductions in: &nb…
Published	01/07/2025	•Target BP <{{c1::140/90}} mmHg (ideally <130/85) •Long-term {{c1::exercise}} training is associated with:    •c. 10-20mm reduction in…
Published	01/07/2025	•Exercise training is associated with:    •Improved {{c1::glucose}} tolerance    •Lower serum {{c1::insulin}} levels    …
Published	01/07/2025	Six Core Components (BACPR):•Health behaviour change and {{c1::education}} •Lifestyle risk {{c1::factor}} management    •Physical activity a…
Published	01/07/2025	Phase 1:•In-hospital (pre-discharge)    •Clinical {{c1::assessment}}    •E{{c1::ducation}} (?misconceptions)    •R{{c1::…
Published	01/07/2025	Phase 2•At {{c1::home}} – immediately post-discharge •Typically week {{c1::2}} to week {{c1::6}}    •Personal {{c1::exercise}} programme &nb…
Published	01/07/2025	Phase 3•{{c1::Community}} setting (eg local leisure centre/gym) •Typically, from week {{c1::6}} (for up to 6 months) •Exercise programme    …
Published	01/07/2025	Aim for Borg Level {{c1::4-6}} activity in rehabilitation
Published	01/07/2025	Education helps patients to:•Cope with their illness •Improve their health-related quality of life •Improves compliance with:    •{{c1::Life…
Published	01/07/2025	Weight optimisation:•Assess {{c1::diet}}:    •Calorie intake    •(Saturated) fat    •Salt •Target BMI {{c1::18.5-25}} kg…
Published	01/07/2025	Nutrition:•Low {{c1::saturated}} fats    •<7% of total calories •Increased mono-/poly-unsaturates (c. 25%) •(Complex) carbohydrates (c. 6…
Published	01/07/2025	•Screen for {{c1::psychological}} distress    •Anger    •Depression    •Anxiety •Enquire about {{c1::social}} issues &nb…
Published	01/07/2025	Phase 4:•Life-long maintenance •Un{{c1::supervised}} exercise    •At least 2.5 hours/week    •Bouts of at least 10 min, at le…
Published	01/07/2025	Barriers to recruitment/completion•Currently c.{{c1::50}}% of UK patients join a rehab. programme    •CABG – c.{{c1::70}}%    •MIs…
Published	01/07/2025	Barriers to Recruitment:•Patient {{c1::factors}}    •Co-morbidities    •‘Too ill’    •Apathy •Lack of {{c1::home}} suppo…
Published	01/07/2025	Options to improve recruitment and completion:•Alternative {{c1::delivery}} modes in keeping with patients’ needs/preferences •Home-based delivery (8%…
Published	01/07/2025	Six Standards (BACPR):•Delivery of the 6 core components by a {{c1::multidisciplinary}} team •Prompt {{c1::identification}} and recruitment of eligibl…
Published	01/07/2025	Clinical Audits:•Powerful tool to address:    •Variation in clinical standards    •Inequalities in health provision •Guidelines fr…
Published	01/07/2025	KPI's:•Team includes at least {{c1::3}} staff types •Programme includes all priority groups •Phase 3 programme lasts at least {{c1::8}} weeks •Phase 3…
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