Expensive, specialist-led programs for people recovering from heart attacks are no more effective than shorter ones offered in the community or family care settings, a new study finds.
The University of Alberta study, published this month in the European Journal of Cardiovascular Health, reviews 46 randomized trials of programs intended to help heart attack patients return to living normal lives.
Shorter cardiac rehab programs offer an attractive and highly efficient alternative to longer, more costly and often less accessible hospital ones, says study author Alexander Clark.
(CBC)
It finds that overall the programs do improve life expectancy and reduce hospitalizations — but that those shorter than 10 hours and in family care settings are just as effective as lengthier specialist-led programs in hospitals.
Given the findings, and the fact that many of the hospital-based programs are underutilized with only 30 per cent attendance, the authors say that lower-cost, easier-to-access programs could be promoted and administered.
"As the shorter and more generalist programs are just as effective at saving patients' lives, these offer an attractive and highly efficient alternative to longer, more costly, and often less accessible hospital programs," Dr. Alexander Clark, the lead author on the study, said in a release.
Better patient care
The news is reassuring for community-based medical groups.
"For us, this is encouraging research because we've been developing a menu of services so we have short programs," Dr. Bill Dafoe, director of Capital Health's cardiac rehab program, told CBC News.
He said doctors have historically expressed concern about shorter programs, thinking them to be less effective. Patients too have believed the longer programs are better for rehabilitation.
"People can be assured that if they come on shorter programs that they're not being short-changed," he said.
People with more complicated heart conditions can benefit from longer programs provided by specialists, the authors say, leaving those with less complex cases to seek help through family doctors.
"This is something that can be taught to health care providers across the country and in smaller areas and rural communities," said Dr. Beth Abramson a spokeswoman for the Heart and Stroke Foundation of Canada. "I think this will allow for better patient care across the country."
The total cost of cardiovascular diseases on the health sector of the Canadian economy is more than $18.4 billion a year — 11.6 per cent of the total cost of all illnesses — according to Health Canada's latest figures.
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