Conclusions : Telehealth interventions with a range of delivery modes could be offered to patients who can not attend cardiac rehabilitation , or as an adjunct to cardiac rehabilitation for effective secondary prevention
Background : Coronary heart disease ( CHD ) is a major cause of death worldwide .
Cardiac rehabilitation , an evidence -based CHD secondary prevention programme , remains underutilized .
Telehealth may offer an innovative solution to overcome barriers to cardiac rehabilitation attendance .
We aim ed to determine whether contemporary telehealth interventions can provide effective secondary prevention as an alternative or adjunct care compared with cardiac rehabilitation and /or usual care for patients with CHD .
How many patients with coronary heart disease are not achieving their risk-factor targets? Experience in Victoria 1996-1998 versus 1999-2000.
OBJECTIVES To determine the proportion of patients with established coronary heart disease ( CHD ) in two Australian studies ( VIC-I in 1996 - 1998 , and VIC-II in 1999 - 2000 ) who achieved their risk-factor targets as recommended by the National Heart Foundation of Australia , and to compare this proportion with those in studies from the United Kingdom ( ASPIRE ) , Europe ( EUROASPIRE I and II ) and the United States ( L-TAP ) . DESIGN AND SETTING Prospect i ve cohort study with  VIC-I set in a single Melbourne university teaching hospital and VIC-II set in six university teaching hospitals in Melbourne , Victoria . PARTICIPANTS 460 patients ( 112 in VIC-I , 348 in VIC-II ) who completed follow-up in the control groups of two r and omised controlled trials of a coaching intervention in patients with established CHD . MAIN OUTCOME MEASURES The treatment gap ( 100 % , minus the percentage of patients achieving the target level for a particular modifiable risk factor ) at six months after hospitalisation . RESULTS The treatment gap declined from 96.4 % ( 95 % CI , 91%-99 % ) to 74.1 % ( 95 % CI , 69%-79 % ) for total cholesterol concentration ( TC ) < 4.0 mmol/L ( P = 0.0001 ) and from 90.2 % ( 95 % CI , 83%-95 % ) to 54.0 % ( 95 % CI , 49%-59 % ) for TC < 4.5 mmol/L ( P = 0.0001 ) . This reduction in the treatment gap between VIC-I and VIC-II appears to be entirely explained by an increase in the number of patients prescribed lipid-lowering drugs . The treatment gaps in the UK and two European studies were substantially greater . The treatment gap for blood pressure ( systolic > or = 140 mmHg and /or diastolic > or = 90 mmHg ) in VIC-II was 39.5 % , again less than corresponding European data . There were 8.1 % of patients who had unrecognised diabetes in VIC-II ( fasting glucose level > or = 7 mmol/L ) , making a total of 25.6 % of VIC-II patients with diabetes , self-reported or unrecognised . The proportion of patients in VIC-II who were obese ( body mass index > or = 30 kg/m2 ) was similar to the overseas studies , while fewer patients in VIC-II smoked compared with those in the UK and European studies . CONCLUSIONS A substantial treatment gap exists in Victorian patients with established CHD . The treatment gap compares well with international surveys and , at least in the lipid area , is diminishing
Conclusions : Telehealth interventions with a range of delivery modes could be offered to patients who can not attend cardiac rehabilitation , or as an adjunct to cardiac rehabilitation for effective secondary prevention
Background : Coronary heart disease ( CHD ) is a major cause of death worldwide .
Cardiac rehabilitation , an evidence -based CHD secondary prevention programme , remains underutilized .
Telehealth may offer an innovative solution to overcome barriers to cardiac rehabilitation attendance .
We aim ed to determine whether contemporary telehealth interventions can provide effective secondary prevention as an alternative or adjunct care compared with cardiac rehabilitation and /or usual care for patients with CHD .