Evaluation of Telephone-Based Cardiac Rehabilitation Services Delivered to Adults 65 and Older During the Early Months of the COVID-19 Pandemic

Abstract

This study was performed to evaluate the effectiveness of a hybrid, telephone-based cardiac rehabilitation (TBCR) program implemented early in the COVID-19 pandemic compared with in-person, center-based programming offered prior to the pandemic. The focus was on older adults’ engagement and outcomes. Matched groups of hybrid and in-person cardiac rehabilitation (CR) participants were created from existing data and compared using t-tests and repeated measures ANOVAs. Qualitative interviews were conducted with participating CR staff then transcribed, coded, and analyzed for key themes. There were significant differences in body mass index and weight from pre-to post-CR within both hybrid and in-person groups. Despite this, CR staff believed exercise adherence was reduced in the hybrid group when compared to those in the in-person program. In the future, TBCR should be considered as an adjunct to in-person CR. Reluctance to prescribe exercise needs to be addressed through CR staff training.

Keywords

cardiac rehabilitation telephone-based intervention COVID-19

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References

American Association of Cardiovascular and Pulmonary Rehabilitation (2021). AACVPR fact sheet: Virtual delivery of cardiac and pulmonary rehabilitation opportunities during the COVID-19 pandemic. Retrieved from https://www.aacvpr.org/Portals/0/2020_9_23_AACVPR_Fact-Sheet-for-Virtual-Delivery-of-CR-and-PR.pdf

Choi

N. G.

DiNitto

D. M.

Marti

C. N.

Choi

B. Y.

(2022). Telehealth use among older adults during COVID-19: Associations with sociodemographic and health characteristics, technology device ownership, and technology learning. Journal of Applied Gerontology, 41(3), 600–609. https://doi.org/10.1177/07334648211047347

Conley

K. L.

Whitacre

B. E.

(2020). Home is where the internet is? High-speed internet’s impact on rural housing values. International Regional Science Review, 43(5), 501–530. https://doi.org/10.1177/0160017620918652

Creswell

J.W.

Poth

(2017). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications, Inc.

Dahlöf

(2010). Cardiovascular disease risk factors: Epidemiology and risk assessment. The American Journal of Cardiology, 105(1), 3A–9A. https://doi.org/10.1016/j.amjcard.2009.10.007

Franzosa

Gorbenko

Brody

A. A.

Leff

Ritchie

C. S.

Kinosian

B. A. D.

Ornstein

K. A.

(2021). There is something very personal about seeing someone’s face”: Provider perceptions of video visits in home-based primary care during COVID-19. Journal of Applied Gerontology, 40(11), 1417–1424. https://doi.org/10.1177/07334648211028393

Giuliano

Parmenter

B. J.

Baker

M. K.

Mitchell

B. L.

Williams

A. D.

Lyndon

Mair

Maiorana

Smart

N. A.

Levinger

(2017). Cardiac rehabilitation for patients with coronary artery disease: A practical guide to enhance patient outcomes through continuity of care. Clinical Medicine Insights: Cardiology, 11(1–7), 1179546817710028. https://doi.org/10.1177/1179546817710028

Granger

B. B.

Bosworth

H. B.

(2011). Medication adherence: Emerging use of technology. Current Opinion in Cardiology, 26(4), 279–287. https://doi.org/10.1097/HCO.0b013e328347c150

Hajduk

A. M.

Hyde

J. E.

Waring

M. E.

Lessard

D. M.

McManus

D. D.

Fauth

E. B.

Lemon

S. C

Saczynski

J. S.

(2018). Practical care support during the early recovery period after acute coronary syndrome. Journal of Applied Gerontology, 37(7), 881–903. https://doi.org/10.1177/0733464816684621

10.

Heron

(2019). Deaths: Leading causes for 2017. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 68(6), 9–13. https://stacks.cdc.gov/view/cdc/79488

11.

Jin

Tanaka

Bandinelli

Ferrucci

Talegawkar

S. A.

(2017). Overall cardiovascular health is associated with all-cause and cardiovascular disease mortality among older community-dwelling men and women. Journal of Aging and Health, 29(3), 437–453. doi: https://doi.org/10.1177/0898264316635590. https://doi.org/10.1177/0898264316635590

12.

Johnson

R. B.

Onwuegbuzie

A. J.

(2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14–26. https://doi.org/10.3102/0013189X033007014

13.

Marra

D. E.

Hamlet

K. M.

Bauer

R. M.

Bowers

(2020). Validity of teleneuropsychology for older adults in response to COVID-19: A systematic and critical review. The Clinical Neuropsychologist, 34(7–8), 1411–1452. https://doi.org/10.1080/13854046.2020.1769192

14.

Molloy

G. J.

Perkins-Porras

Bhattacharyya

M. R.

Strike

P. C.

Steptoe

(2008). Practical support predicts medication adherence and attendance at cardiac rehabilitation following acute coronary syndrome. Journal of Psychosomatic Research, 65(6), 581–586. https://doi.org/10.1016/j.jpsychores.2008.07.002

15.

Nakayama

Takayama

Kobayashi

Hyodo

Maeshima

Takayuki

Morita

Komuro

(2020). Remote cardiac rehabilitation is a good alternative of outpatient cardiac rehabilitation in the COVID-19 era. Environmental Health and Preventative Medicine, 25(48), 48. https://doi.org/10.1186/s12199-020-00885-2

16.

National Heart, LungBlood Institute (2020). Cardiac rehabilitation. https://www.nhlbi.nih.gov/health-topics/cardiac-rehabilitation#:∼:text=Cardiac%20rehabilitation%2C%20also%20called%20cardiac,grafting%2C%20or%20percutaneous%20coronary%20intervention

17.

Onyeaka

H. K.

Romero

Healy

B. C.

Celano

C. M.

(2021). Age differences in the use of health information technology among adults in the United States: An analysis of the Health Information National Trends Survey. Journal of Aging and Health, 33(1–2), 147–154. https://doi.org/10.1177/0898264320966266

18.

Rawston

Gant

Direito

Beckmann

Maddison

(2016). Telehealth exercise-based cardiac rehabilitation: A systematic review and meta-analysis. Heart, 102(15), 1183–1192. https://doi.org/10.1136/heartjnl-2015-308966

19.

Schopfer

Forman

(2016). Cardiac rehabilitation in older adults. Canadian Journal of Cardiology, 32(9), 1088–1096. https://doi.org/10.1016/j.cjca.2016.03.003

20.

Smith

S. C.

Benjamin

E. J.

Bonow

R. O.

Braun

L. T.

Creager

M. A.

Franklin

B. A.

Gibbons

R. J.

Grundy

S. M.

Hiratzka

L. F.

Jones

D. W.

Lloyd-Jones

D. M.

Minissian

Mosca

Peterson

E. D.

Sacco

R. L.

Spertus

Stein

J. H.

Taubert

K. A.

(2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American heart association and American college of cardiology foundation endorsed by the world heart federation and the preventive cardiovascular nurses association. Journal of the American College of Cardiology, 58(23), 2432–2446. https://doi.org/10.1161/CIR.0b013e318235eb4d

21.

Soares-Miranda

Siscovick

Psaty

Longstreth

Jr. Mozaffarian

(2015). Physical activity and risk of coronary heart disease and stroke in older adults: The Cardiovascular Health Study. Circulation, 133(2), 147–155. https://doi.org/10.1161/CIRCULATIONAHA.115.018323

22.

Suaya

Shepard

Normand

S-L.

Ades

Prottas

Stason

(2007). Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation, 116(15), 1653–1662. https://doi.org/10.1161/CIRCULATIONAHA.107.701466

23.

Thomas

Beatty

Beckie

Brewer

Brown

Forman

Franklin

Keteyian

Kitzman

Regensteiner

Sanderson

Whooley

(2019). Home-based cardiac rehabilitation: A scientific statement from the American association of cardiovascular and pulmonary rehabilitation, the American heart association, and the American college of cardiology. Circulation, 140(1), Article e69–e89. https://doi.org/10.1161/CIR.0000000000000663

24.

Tong

Sainsbury

Craig

(2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

25.

Traywick

L. S.

Schoenberg

N. E.

(2008). Determinants of exercise among older female heart attack survivors. Journal of Applied Gerontology, 27(1), 52–77. https://doi.org/10.1177/0733464807308604

26.

Wakefield

Drwal

Scherubel

Klobucar

Johnson

Kaboli

(2014). Feasibility and effectiveness of remote, telephone-based delivery of cardiac rehabilitation. Telemedicine and E-Health, 20(1), 32–38. https://doi.org/10.1089/tmj.2013-0079

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