Improving Cardiac Rehabilitation Participation in Women and Men

Study Overview
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Brief Summary
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The purpose of this study is to determine the effect of a pre-discharge written personal endorsement to the patient by the patient's attending cardiologist or cardiac surgeon (MD endorsement) to take part in the Cardiac Rehabilitation and Secondary Prevention (CR) program, in addition to the standard CR referral, compared to the standard CR referral alone, on CR program enrollment within 2 months of index hospital discharge following admission for myocardial infarction, unstable angina, coronary angioplasty, or coronary artery bypass.

Detailed Description
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There is compelling evidence that a comprehensive CR program comprising the delivery of lifestyle modifying education will reduce mortality, morbidity and improve quality of life in patients following myocardial infarction, angioplasty or, coronary artery bypass. However, less than 20% of eligible patients participate in CR programs. This study will look at a method of potentially improving enrollment and adherence to a CR program. It is expected that patients who receive the MD-endorsed referral will be more likely to attend the initial Orientation appointment and more closely adhere to the 6-month comprehensive CR program, as compared to the patients who receive a standard CR referral alone.

Official Title
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Improving Cardiac Rehabilitation Participation in Women and Men

Conditions
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Myocardial Infarction, Unstable Angina, Coronary Disease

Intervention / Treatment
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* Behavioral: MD-endorsed Cardiac Rehabilitation referral
* Behavioral: Standard Cardiac Rehabilitation referral


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient is admitted to hospital for myocardial infarction (MI), unstable angina (UA), percutaneous transluminal coronary angioplasty (PTCA), or coronary artery bypass surgery (CABS) Patient resides within 1 hour driving time from London Exclusion Criteria: Inability to provide written informed consent or complete survey due to language or cognitive difficulties Previous cardiac rehabilitation participation Patient scheduled to undergo PTCA or CABS within two months following the index hospital discharge Inability to exercise due to musculoskeletal problems or previous or current stroke

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Usual Care<br>Comparator without MD endorsement of Cardiac Rehabilitation | Behavioral: Standard Cardiac Rehabilitation referral<br>* Note to patient with general description of the Cardiac Rehabilitation program without signature or recommendation from attending physician.<br>* Other names: Standard Referral to Cardiac Rehabilitation;|
| Experimental: MD Endorsment of CR<br>Provided with MD endorsement of participation in Cardiac Rehabilitation | Behavioral: MD-endorsed Cardiac Rehabilitation referral<br>* Note to patient with general description of the Cardiac Rehabilitation program with signature and strong recommendation from attending physician.<br>* Other names: MD endorsed referral to Cardiac Rehabilitation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attendance at initial CR orientation appointment within 2 months of index hospital discharge |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of MD endorsement on number of patients attending CR program |  | 3 months | 
| Number of patients who continue to adhere to the 6-month CR program beyond the initial CR orientation appointment |  | 8 months | 
| Impact of other patient variables and how they influence participation in a CR program |  | 8 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiac Rehabilitation, Improving Cardiac Rehabilitation Participation, coronary angioplasty, coronary artery bypass surgery