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The hypothesis is that home based clinical rehabilitation (CR) is less expensive than hospital based CR with similar clinical effectiveness. The investigators will compare the results of two forms of CR on
The main reasons for patients not to participate in a cardiac rehabilitation program that usually develops by group in the hospital or in a gym, are problems of access to hospital, disgust for participating in a group activity and problems in reconciling their work and / or home with the program schedule. These problems could be overcome by outcome cardiac rehabilitation and thus could increase the number of patients benefit from treatment in either the environment extra or intra-hospital.
Low and medium coronary patients sent to cardiac rehabilitation program at our center within the first 12 weeks after presenting with acute coronary syndrome or been revascularized will be included in the study. The prescription of intensity of effort is based on heart rate reached during the stress test for the initial evaluation in all cases, although at home-program heart rate will be monitored using heart rate monitor and / or by the Borg scale. In this way outpatient group patient could performed training sessions individually and at the time of day that best suits their capabilities. The other program components: control of risk factors, health education and counseling will be identical in both groups of patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hospital cardiac rehabilitation | Experimental | The patients will perform physical training sessions in the hospital |
|
| Home cardiac rehabilitation | Active Comparator | The patients will perform physical training sessions at home |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiac rehabilitation | Behavioral |
|
| Measure | Description | Time Frame |
|---|---|---|
| Morbidity | Readmissions, percutaneous or surgical revascularization | 1 year |
| Cost |
| 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Control of risk factors | Control of risk factors at the end of training sessions and one year after the acute event: Percentage of patients achieving the therapeutic goal outlined in the clinical practice guidelines in each of the risk factors | 1 year |
| Functional capacity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fernando Aros Borau | Contact | +34 945 007000 | LUISFDO.AROSBORAU@osakidetza.net |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Araba University Hospital | Vitoria-Gasteiz | Álava | 01009 | Spain |
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| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D000072038 | Cardiac Rehabilitation |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
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|
| Cardiac rehabilitation | Behavioral | The only difference in the hospital's program is that training sessions will be out of hospital with the same target heart rate that in this case will be controlled with pulsometer or Borg scale. The recommended frequency of sessions will be: at least 5 days a week with a minimum of 1 hour / day. |
|
Oxygen consumption peak measured during exercise testing |
| 1 year |
| Quality of Life | SF-12 version 2 | 1 year |
| Satisfaction | satisfaction questionnaire based on Osakidetza Basque Health Service questionnaires | 1 year |
| Mortality | All cause mortality | 1 year |
| D013812 |
| Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |