MECRIS: Effect of an Educational Intervention on Cardiac Patients' Participation Rate in Cardiac Rehabilitation Programs

• Sponsor: Sheba Medical Center (Other)
• Overall Status: Completed
• CT.gov ID: NCT00356863
• Collaborator: The Gertner Institute (Other), Israel National Institute for Health Policy and Health Services Research (Other)
• Enrollment: 1,024
• Location: 1
• Arms: 2
• Duration (Months): 70
• Patients Per Site Per Month: 14.6

Study Details

Study Description

Brief Summary

The main aim of the study is to determine the effectiveness of an educational intervention designed to increase attendance of coronary artery bypass grafting (CABG) patients at Cardiac Rehabilitation Programs (CRPs) on actual CRP participation rate and; examine patient-related factors (demographic, health, psychosocial, awareness) influencing patients' attendance at CRPs. We hypothesized that the proportion of CABG patients participating in CRPs will increase significantly to 20-30% following the educational intervention employed.

Condition or Disease	Intervention/Treatment	Phase
Coronary Artery Disease	Behavioral: Increasing awareness to cardiac rehabilitation programs	N/A

Detailed Description

Coronary heart disease (CHD) is a major cause of disability and economic burden in western societies. Ample evidence exists to suggest that participation of these patients in structured Cardiac Rehabilitation Programs (CRPs) is beneficial in terms of improved prognosis and quality of life. Despite inclusion of cardiac rehabilitation (CR) in the Medical Insurance Basket (MIB) as a treatment for patients after an acute myocardial infarction (MI), for those after coronary artery bypass grafting (CABG), and more recently for patients suffering from congestive heart failure, only a small proportion (5%-7.5%) of patients take part in CRPs in Israel. Several factors have been identified as barriers to CRP in Israel, two of which are lack of patients motivation to participate in CRPs stemming, in part, from lack of awareness regarding the importance of CR and its availability and; Lack of motivation of medical staff to refer patients to CR resulting from a unawareness of the importance of CR and its availability across Israel, to name a few. The present study accords with such recommendations, by proposing a simple intervention designed to improve patients' and medical staff's awareness to the importance of CR participation. It is expected that CRP participation will significantly increase to 20-30% following the educational intervention employed.

This intervention will provide the basis for the implementation of an intervention to increase CRP participation in cardiac patients at a national level.

In addition to increasing the proportion of CABG patients attending at CRPs, the study aims to measure the effect of CRP participation on subsequent 1-year health and behavior related outcomes, and 3-year mortality. We expect to find differences in outcome measures between participating patients and those who do not.

Study Design

• Study Type: Interventional
• Actual Enrollment: 1024 participants
• Allocation: Non-Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Prevention
• Official Title: The Influence of Increasing Awareness of Cardiac Patients Undergoing Coronary Artery Bypass Grafting (CABG) Surgery to Cardiac Rehabilitation (CR) on Actual Participation Rates and; Patients' Related Barriers to CR Programs Participation
• Study Start Date: Feb 1, 2004
• Actual Primary Completion Date: Jun 1, 2009
• Actual Study Completion Date: Dec 1, 2009

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Explanation on cardiac rehabilitation Intervention: Increasing awareness to cardiac rehabilitation programs: Patients received a written and oral short explanation on the importance and benefits of cardiac rehabilitation (CR) participation, and information on available programs. They were telephoned 2 weeks after hospital discharge to encourage them to enroll at a cardiac rehabilitation program (CRP). In addition, physicians and nurses at the cardiothoracic units participated in a 1-hour seminar on CR. A recommendation to the general physician to refer the patient to CRP was added to the letter of discharge from hospital.	Behavioral: Increasing awareness to cardiac rehabilitation programs; Increasing awareness to cardiac rehabilitation programs: Before coronary artery bypass grafting (CABG) surgery patients received a face-to-face explanation on their right to participate in cardiac rehabilitation programs (CRPs) under the Israeli Basket of Health Services; they were also provided with a brochure on the benefits of CRP participation and the availability of CRPs throughout the country.; Other Names: Improving participation at cardiac rehabilitation programs
No Intervention: Usual care with no intervention Patients recruited to the study received the usual care without any additional explanation on cardiac rehabilitation, and no effort to increase their awareness or the ward's awareness to cardiac rehabilitation was done.

Outcome Measures

Primary Outcome Measures

1. Number of Patients Participating in Cardiac Rehabilitation Programs (CRPs)1-year Post Coronary Artery Bypass Grafting (CABG)Surgery in the Intervention and Control Groups [1 year]

   The number of cardiac patients who participated in cardiac rehabilitation programs during the year following coronary artery bypass grafting surgery in the control and the intervention groups.

Secondary Outcome Measures

1. MacNew Heart Disease Health Related Quality of Life (HRQL) Scale. A Self-administered Heart Disease-specific Health-related Quality of Life (HRQL) Instrument. [1 year]

   MacNew questionnaire (MACNEW). A self-administered heart disease-specific health-related quality of life (HRQL) instrument. The MacNew is a modification of the original interviewer-administered Quality of Life after Myocardial Infarction [QLMI] instrument. It addresses three major HRQL domains, the Emotional, Physical, and Social domains which can be combined to give a Global HRQL score. The MacNew consists of 27 items. The total mean score ranges between 1 and 7, where higher score means better HRQL.

Other Outcome Measures

1. Cardiovascular Morbidity [1 year]

   All hospitalizations which occured during the 1 year follow-up and were due to acute myocardial infarction (International Classification of Disease 9th version (ICD-9) codes 410.), angina pectoris (ICD-9 codes 413.9), stroke/ transient ischemic attack (TIA) (ICD-9 codes 436.), and all surgical procedures which occured during the 1 year follow-up: CABG or coronary catheterizations (ICD-9 codes 36.), endarterectomies (ICD-9 codes 38.0 and 39.0).

2. Biochemical Markers [1 year]

   glucose, total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol. Data regarding these biochemical markers was collected from medical available documents at the homes of the patients. In many cases this data was unavailable. Reported values are only available for a subpopulation.

3. Medical Service Utilization [1 year]

   Visits to the emergency department during the year following CABG surgery

4. Anthropometric Measures [1 year]

   Measurements of body mass index (BMI)

5. Lifestyle Habits (i.e. Smoking) [1 year]

6. Employment Status [1 year]

   Number of patients fully employed in each arm

7. Depression & Anxiety [1 year]

   Score in the HADS (hospital Anxiety and Depression Scale) screening for anxiety and depression. This is a 14 item scale, 7 items for anxiety and 7 items for depression. Each item can score 0-3 (0=good, 3=bad) and the total score for each scale varies between 0 (no depression/anxiety) to 21 (clinical depression/anxiety requiring medical intervention)

8. Physical Activity [1 year]

   Self-reported physical activity using a physical activity questionnaire validated in Hebrew. Details of the study validating the instrument: "Development of a Hebrew questionnaire to be used in epidemiological studies to assess physical fitness--validation against sub maximal stress test and predicted VO2max". Ken-Dror G, Lerman Y, Segev S, Dankner R. Harefuah. 2004 Aug;143(8):566-72, 623. Hebrew. PMID: 15523807 VO2max=maximal oxygen uptake

9. Blood Pressure [1 year follow up]

   The pooled mean of 3 blood pressure measurements taken during the interview

Eligibility Criteria

Criteria

• Ages Eligible for Study: N/A and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Patients undergoing Coronary Artery Bypass Grafting with or without valve replacement

Exclusion Criteria:

• Institutionalized patients

• Patients with severe co-morbidities for whom cardiac rehabilitation (CR) is contra-indicated

• Patients who sustained a severe surgical complication preventing them from participating in CR (general stroke with severe disability)

• Patients residing farther than 30 km from a rehabilitation center

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Sheba Medical Center, the Gertner institute for epidemiology and health service research	Ramat Gan		Israel	52621

Sponsors and Collaborators

• Sheba Medical Center
• The Gertner Institute
• Israel National Institute for Health Policy and Health Services Research

Investigators

• Principal Investigator: Rachel Dankner, MD MPH, The Gertner Institute for Epidemiology and Health Service Research, Sheba Medical Center

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

• THE PSYCHOMETRIC PROPERTIES OF THE RUSSIAN VERSION OF THE MACNEW HEART DISEASE HEALTH-RELATED QUALITY OF LIFE SCALE IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING SURGERY
• Validation of the Hebrew Version of the MacNew Heart Disease Healthrelated Quality of Life Questionnaire in Patients Undergoing Coronary Artery Bypass Surgery

Publications

• Dankner R, Drory Y, Geulayov G, Ziv A, Novikov I, Zlotnick AY, Moshkovitz Y, Elami A, Schwammenthal E, Goldbourt U. A controlled intervention to increase participation in cardiac rehabilitation. Eur J Prev Cardiol. 2015 Sep;22(9):1121-8. doi: 10.1177/2047487314548815. Epub 2014 Sep 2.

• Responsible Party: Dr. Rachel Dankner, Senior investigator, Sheba Medical Center
• ClinicalTrials.gov Identifier: NCT00356863
• Other Study ID Numbers: SHEBA-05-2374-RD-CTIL
• First Posted: Jul 26, 2006
• Last Update Posted: Nov 20, 2017
• Last Verified: Oct 1, 2017

• Keywords provided by Dr. Rachel Dankner, Senior investigator, Sheba Medical Center: Intervention; Awareness; Cardiac Rehabilitation (CR); Coronary Artery Patients; Coronary Artery Bypass Grafting Surgery (CABG)
• Additional relevant MeSH terms: Coronary Artery Disease

Study Results

Participant Flow

Recruitment Details	All cardiac patients hospitalized in 5 cardiothoracic clinics for coronary artery bypass grafting (CABG) surgery (with or without valve replacement) were offered to participate in the study based on inclusion criteria. Recruitment started on January 2004 and ended on November 2006.
Pre-assignment Detail	All first 520 recruited participants from the 5 cardiothoracic units belonged to the control arm of the study and received usual care. The following 504 patients recruited in the 5 cardiothoracic units belonged to the intervention arm and received the educational intervention materials of the study regarding cardiac rehabilitation treatment.

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Period Title: Overall Study
STARTED	504	520
COMPLETED	412	445
NOT COMPLETED	92	75

Baseline Characteristics

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)	Total
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.	Total of all reporting groups
Overall Participants	504	520	1024
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	65.644 (9.904)	66.146 (10.789)	65.902 (10.01)
Sex: Female, Male (Count of Participants)
Female	110 21.8%	134 25.8%	244 23.8%
Male	394 78.2%	386 74.2%	780 76.2%
Region of Enrollment (participants) [Number]
Israel	504 100%	520 100%	1024 100%

Outcome Measures

1. Primary Outcome

Title	Number of Patients Participating in Cardiac Rehabilitation Programs (CRPs)1-year Post Coronary Artery Bypass Grafting (CABG)Surgery in the Intervention and Control Groups
Description	The number of cardiac patients who participated in cardiac rehabilitation programs during the year following coronary artery bypass grafting surgery in the control and the intervention groups.
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

All patients alive at 1-year follow up who gave information on participation in cardiac rehabilitation programs (CRPs) at any time during the year following surgery (and before follow up assessment). This information was obtained via a face-to-face interview or by telephone interview.

Arm/Group Title	Education (Intervention) on Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about CR and were giving the usual care.
Measure Participants	450	454
Number [participants]	156 31%	86 16.5%

2. Other Pre-specified Outcome

Title	Cardiovascular Morbidity
Description	All hospitalizations which occured during the 1 year follow-up and were due to acute myocardial infarction (International Classification of Disease 9th version (ICD-9) codes 410.), angina pectoris (ICD-9 codes 413.9), stroke/ transient ischemic attack (TIA) (ICD-9 codes 436.), and all surgical procedures which occured during the 1 year follow-up: CABG or coronary catheterizations (ICD-9 codes 36.), endarterectomies (ICD-9 codes 38.0 and 39.0).
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

All patients who were exposed to the educational intervention at baseline and who were contacted a year later and gave information regarding participation in cardiac rehabilitation during the follow up year.

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Measure hospitalizations	221	292
Acute myocardial infarction (MI)	61	84
Acute, but ill-defined cerebrovascular disease (a	31	35
Angina Pectoris	6	8

3. Other Pre-specified Outcome

Title	Biochemical Markers
Description	glucose, total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol. Data regarding these biochemical markers was collected from medical available documents at the homes of the patients. In many cases this data was unavailable. Reported values are only available for a subpopulation.
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Glucose	120.4 (58.0)	123.1 (64.8)
Total Cholesterol	164.4 (38.5)	170.6 (43.5)
Triglycerides	141.7	142.1
LDL Cholesterol	95.3	96.8

4. Other Pre-specified Outcome

Title	Medical Service Utilization
Description	Visits to the emergency department during the year following CABG surgery
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Number [ER visits]	78	74

5. Other Pre-specified Outcome

Title	Anthropometric Measures
Description	Measurements of body mass index (BMI)
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Body Mass Index (BMI) men	28.0 (4.4)	27.3 (4.4)
Body Mass Index (BMI) women	28.9	28.4

6. Other Pre-specified Outcome

Title	Lifestyle Habits (i.e. Smoking)
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Current smoker	38	46
Past smoker	208	215
Never smoked	157	167

7. Other Pre-specified Outcome

Title	Employment Status
Description	Number of patients fully employed in each arm
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Number [patients]	88	82

8. Other Pre-specified Outcome

Title	Depression & Anxiety
Description	Score in the HADS (hospital Anxiety and Depression Scale) screening for anxiety and depression. This is a 14 item scale, 7 items for anxiety and 7 items for depression. Each item can score 0-3 (0=good, 3=bad) and the total score for each scale varies between 0 (no depression/anxiety) to 21 (clinical depression/anxiety requiring medical intervention)
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

All patients who completed the Hospital Anxiety and Depression Scale (HADS)

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Anxiety (0=low; 21=high)	4.66 (4.08)	5.33 (4.21)
Depression (0=low ; 21=high)	4.49 (4.32)	4.66 (4.09)

9. Other Pre-specified Outcome

Title	Physical Activity
Description	Self-reported physical activity using a physical activity questionnaire validated in Hebrew. Details of the study validating the instrument: "Development of a Hebrew questionnaire to be used in epidemiological studies to assess physical fitness--validation against sub maximal stress test and predicted VO2max". Ken-Dror G, Lerman Y, Segev S, Dankner R. Harefuah. 2004 Aug;143(8):566-72, 623. Hebrew. PMID: 15523807 VO2max=maximal oxygen uptake
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

All patients who were interviewed 1-year after CABG surgery and responded to the physical activity questionnaire

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Physically active in any sports	190	162
Sedentary (no sports activities)	223	279

10. Secondary Outcome

Title	MacNew Heart Disease Health Related Quality of Life (HRQL) Scale. A Self-administered Heart Disease-specific Health-related Quality of Life (HRQL) Instrument.
Description	MacNew questionnaire (MACNEW). A self-administered heart disease-specific health-related quality of life (HRQL) instrument. The MacNew is a modification of the original interviewer-administered Quality of Life after Myocardial Infarction [QLMI] instrument. It addresses three major HRQL domains, the Emotional, Physical, and Social domains which can be combined to give a Global HRQL score. The MacNew consists of 27 items. The total mean score ranges between 1 and 7, where higher score means better HRQL.
Time Frame	1 year

Outcome Measure Data

Analysis Population Description

The N for this outcome is the number of patients for whom there are follow-up data after one year.

Arm/Group Title	Educational (Intervention) on Cardiac Rehabilitation (CR)	No Education (Control) About Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	413	441
Mean (Standard Deviation) [Scores on a scale]	5.58 (0.94)	5.27 (0.89)

11. Other Pre-specified Outcome

Title	Blood Pressure
Description	The pooled mean of 3 blood pressure measurements taken during the interview
Time Frame	1 year follow up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)	No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.	Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
Measure Participants	450	454
Systolic	131.9	130.8
Diastolic	74.6	74.6

Adverse Events

Time Frame	1-year follow up after baseline interview.
Adverse Event Reporting Description	Baseline interview was conducted during hospitalization period before CABG surgery.
Arm/Group Title	Education (Intervention) Regarding Cardiac Rehabilitation (CR)		No Education (Control) Regarding Cardiac Rehabilitation (CR)
Arm/Group Description	Cardiac patients were encouraged to participate in cardiac rehabilitation (CR) following coronary artery bypass grafting (CABG) surgery. Medical staff in the operating cardiothoracic units (surgeons and nurses) were encouraged to refer patients to CR.		Cardiac patients undergoing coronary artery bypass grafting (CABG) surgery receive the usual care without being exposed to the educational intervention. The staff in the cardiothoracic units (surgeons and nurses) did not receive any information about cardiac rehabilitation (CR) and were giving the usual care.
All Cause Mortality
	Education (Intervention) Regarding Cardiac Rehabilitation (CR)		No Education (Control) Regarding Cardiac Rehabilitation (CR)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	/ (NaN)		/ (NaN)
Serious Adverse Events
	Education (Intervention) Regarding Cardiac Rehabilitation (CR)		No Education (Control) Regarding Cardiac Rehabilitation (CR)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	114/504 (22.6%)		159/523 (30.4%)
Cardiac disorders
Death	16/504 (3.2%)	16	32/523 (6.1%)	32
acute myocardial infarction, unspecified site	61/504 (12.1%)	61	84/523 (16.1%)	84
other and unspecified angina pectoris	6/504 (1.2%)	6	8/523 (1.5%)	8
Vascular disorders
acute, but ill-defined cerebrovascular disease (apoplexy, n.o.s)/transient cerebral ischemia	31/504 (6.2%)	31	35/523 (6.7%)	35
Other (Not Including Serious) Adverse Events
	Education (Intervention) Regarding Cardiac Rehabilitation (CR)		No Education (Control) Regarding Cardiac Rehabilitation (CR)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/504 (0%)		0/523 (0%)

Limitations/Caveats

Lack of randomization No biochemical tests were performed by the study and information regarding biochemical parameters was drawn from the medical records during baseline and from medical documents during follow up.

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.