October 2016, 24:5

13 October 2016

Original Article

Original Article

Impact of Community-Based Cardiac Rehabilitation on Clinical Parameters of Patients with Cardiovascular Diseases

Kheng Yong Ong, Elise Yap, Yvonne May Fen Chia, Hung Yong Tay, Peter Ting, Sui Yung Chan, Yu Heng Kwan

ASEAN Heart Journal

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Abstract

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Background:

Cardiac rehabilitation (CR) programmes have been shown to improve patient outcomes, but vary widely in their components. The impact of Singapore’s CR programme on clinical outcomes is currently not known.

Objective:

To evaluate the effects of a community-based CR programme on important clinical parameters in patients with cardiovascular disease in Singapore.

Method:

A retrospective cohort study was conducted. Cardiovascular patients who had completed a hospital-based CR programme were included. Patients who continued with community-based CR (n = 94) during the period of 2009-2013 were compared with patients who received regular care (n = 157). Changes in clinical and physical examination parameters between baseline and one-year post follow-up were analyzed. Within-group differences were compared using the paired t-test, while multivariate linear regression was used to compare the changes in the various parameters between the intervention and control groups. The primary outcome measure was low density lipoprotein (LDL) levels.

Results:

Patients in the intervention group had significant lowering of LDL (2.5 to 2.2 mmol/L, p<0.01), while the control group’s LDL increased (2.2 to 2.4 mmol/L, p<0.01). The intervention group had greater improvements in LDL (-0.3 vs. +0.2 mmol/L, p<0.01), triglycerides (-0.1 vs. +0.1 mmol/L, p=0.01), total cholesterol (-0.3 vs. +0.3 mmol/L, p<0.01), fasting blood glucose (-0.5 vs. +0.3 mmol/L, p<0.01), systolic blood pressure (-3.2 vs. +5 mmHg, p<0.01) and diastolic blood pressure (-2.6 vs. +2.8 mmHg, p<0.01).

Conclusion:

The community-based CR programme in Singapore is associated with improvements in several cardiovascular clinical parameters and may be of benefit to cardiovascular patients.

Keywords:

Community - Cardiovascular Disease - Cardiac Rehabilitation - Clinical Outcomes - Low density lipoprotein

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a Department of Pharmacy, Singapore General Hospital, Republic of Singapore,

b Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore,

c Duke-NUS Medical School, Republic of Singapore,

d Heart Wellness Centre, Singapore Heart Foundation, Republic of Singapore,

e Department of Cardiology, National Heart Centre Singapore, Republic of Singapore.

Correspondence to and requests for reprints to be made to Yu Heng Kwan, MD-PhD Candidate, Program in Health Services and Systems Research, Duke-NUS Medical School. 8 College Road, Singapore 169857. Tel: +65 - 9023 1226; Fax: +65 - 6779 1554 Email: yuheng@u.duke.nus.edu Conflict of interest declaration: The authors declare no conflict of interest nor any sources of funding for this study.

© The Author(s) 2016. This article is published with open access by ASEAN Federation of Cardiology.

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