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Анализ доступности и качества организации амбулаторно-поликлинического этапа кардиореабилитации больных с острым инфарктом миокарда: результаты анкетирования пациентов
Анализ доступности и качества организации амбулаторно-поликлинического этапа кардиореабилитации больных с острым инфарктом миокарда: результаты анкетирования пациентов
Головенкин С.Е., Никулина С.Ю., Бубнова М.Г., Савицкий И.В. Анализ доступности и качества организации амбулаторно-поликлинического этапа кардиореабилитации больных с острым инфарктом миокарда: результаты анкетирования пациентов // CardioСоматика. 2025. Т. 16, № 2. С. 127–136. DOI: 10.17816/CS677063 EDN: ZOQDGB
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Аннотация
Обоснование. Анализ мнений пациентов, прошедших реабилитацию после острого инфаркта миокарда (ОИМ), позволит оценить различные аспекты организации амбулаторно-поликлинического этапа кардиореабилитации, выявить существующие проблемы и наметить возможные пути их решения.
Цель. Провести анализ доступности и качества организации амбулаторно-поликлинического этапа кардиореабилитации на основании мнения пациентов, прошедших реабилитацию после ОИМ.
Материалы и методы. Проведено анкетирование 120 пациентов (98 мужчин и 22 женщин) в возрасте от 41 до 74 лет, средний возраст 59,0±8,7 года, прошедших амбулаторно-поликлинический этап кардиореабилитации, с использованием разработанной анкеты, включающей 20 вопросов, позволяющих оценить доступность и качество организации этого вида помощи.
Результаты. Выявлено, что 117 пациентов (97,5%) отмечают положительное влияние на самочувствие пройденного курса реабилитации, 99 (82,5%) заявляют о подробном разъяснении лечащим врачом амбулаторного звена целей и задач реабилитации, 105 (87,5%) в целом положительно оценивают организацию клинической части реабилитационного процесса. В то же время в вопросах организации процесса реабилитации выявлены недостатки: 26 (21,7%) пациентов отметили проблему дозвона по телефону регистратуры, 29 (24,2%) — наличие очереди на прохождение амбулаторного этапа, 45 (37,5%) — удаленность центра реабилитации от места проживания. К сожалению, лишь 58 (48,3%) больных согласны на использование телемедицинских коммуникаций (текстовые сообщения, телефонные звонки, видеоконсультации, приложения в мобильном телефоне и т.д.), если таковые будут предложены.
Заключение. Полученные результаты позволят своевременно и целенаправленно внести коррективы в организацию процесса реабилитации пациентов ОИМ на амбулаторном этапе, что должно положительно отразиться на качестве жизни больных с этой патологией.
Ключевые слова: опросы, анкеты, реабилитация, острый инфаркт миокарда, амбулаторный этап, доступность
AIM: The work aimed to assess the accessibility and quality of the outpatient stage of cardiac rehabilitation based on the opinions of patients who completed rehabilitation after AMI.
METHODS: A survey was conducted among 120 patients (98 men and 22 women) aged 41 to 74 years (mean age, 59.0 ± 8.7 years) who had undergone outpatient cardiac rehabilitation. A custom-designed 20-item questionnaire was used to evaluate the accessibility and quality of care.
RESULTS: A total of 117 patients (97.5%) reported a positive effect of the rehabilitation program on their well-being. Ninety‑nine patients (82.5%) indicated that the goals and objectives of rehabilitation had been clearly explained by their outpatient physician. Overall, 105 patients (87.5%) evaluated the clinical component of rehabilitation positively. However, certain organizational shortcomings were identified: 26 patients (21.7%) reported difficulty reaching the clinic by phone; 29 (24.2%) mentioned waiting lists; and 45 (37.5%) noted long distances to the rehabilitation center. Unfortunately, only 58 patients (48.3%) expressed willingness to use telemedicine options (text messaging, phone calls, video consultations, mobile apps, etc.) if such services were available.
CONCLUSION: The findings may support timely and targeted adjustments to the organization of outpatient rehabilitation for patients with AMI, potentially improving their quality of life.
Keywords: surveys, questionnaires, rehabilitation, myocardial infarction, ambulatory care, health services accessibility
Цель. Провести анализ доступности и качества организации амбулаторно-поликлинического этапа кардиореабилитации на основании мнения пациентов, прошедших реабилитацию после ОИМ.
Материалы и методы. Проведено анкетирование 120 пациентов (98 мужчин и 22 женщин) в возрасте от 41 до 74 лет, средний возраст 59,0±8,7 года, прошедших амбулаторно-поликлинический этап кардиореабилитации, с использованием разработанной анкеты, включающей 20 вопросов, позволяющих оценить доступность и качество организации этого вида помощи.
Результаты. Выявлено, что 117 пациентов (97,5%) отмечают положительное влияние на самочувствие пройденного курса реабилитации, 99 (82,5%) заявляют о подробном разъяснении лечащим врачом амбулаторного звена целей и задач реабилитации, 105 (87,5%) в целом положительно оценивают организацию клинической части реабилитационного процесса. В то же время в вопросах организации процесса реабилитации выявлены недостатки: 26 (21,7%) пациентов отметили проблему дозвона по телефону регистратуры, 29 (24,2%) — наличие очереди на прохождение амбулаторного этапа, 45 (37,5%) — удаленность центра реабилитации от места проживания. К сожалению, лишь 58 (48,3%) больных согласны на использование телемедицинских коммуникаций (текстовые сообщения, телефонные звонки, видеоконсультации, приложения в мобильном телефоне и т.д.), если таковые будут предложены.
Заключение. Полученные результаты позволят своевременно и целенаправленно внести коррективы в организацию процесса реабилитации пациентов ОИМ на амбулаторном этапе, что должно положительно отразиться на качестве жизни больных с этой патологией.
Ключевые слова: опросы, анкеты, реабилитация, острый инфаркт миокарда, амбулаторный этап, доступность
________________________________________________
AIM: The work aimed to assess the accessibility and quality of the outpatient stage of cardiac rehabilitation based on the opinions of patients who completed rehabilitation after AMI.
METHODS: A survey was conducted among 120 patients (98 men and 22 women) aged 41 to 74 years (mean age, 59.0 ± 8.7 years) who had undergone outpatient cardiac rehabilitation. A custom-designed 20-item questionnaire was used to evaluate the accessibility and quality of care.
RESULTS: A total of 117 patients (97.5%) reported a positive effect of the rehabilitation program on their well-being. Ninety‑nine patients (82.5%) indicated that the goals and objectives of rehabilitation had been clearly explained by their outpatient physician. Overall, 105 patients (87.5%) evaluated the clinical component of rehabilitation positively. However, certain organizational shortcomings were identified: 26 patients (21.7%) reported difficulty reaching the clinic by phone; 29 (24.2%) mentioned waiting lists; and 45 (37.5%) noted long distances to the rehabilitation center. Unfortunately, only 58 patients (48.3%) expressed willingness to use telemedicine options (text messaging, phone calls, video consultations, mobile apps, etc.) if such services were available.
CONCLUSION: The findings may support timely and targeted adjustments to the organization of outpatient rehabilitation for patients with AMI, potentially improving their quality of life.
Keywords: surveys, questionnaires, rehabilitation, myocardial infarction, ambulatory care, health services accessibility
Полный текст
Список литературы
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20. Aronov DM, Bubnova MG, Drapkina OM. Non-pharmacological therapy of patients with cardiovascular diseases in cardiac rehabilitation programs. Russian Journal of Preventive Medicine. 2020;23(6–2):57–64. doi: 10.17116/profmed20202306257
21. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Statistics in Medicine. 1998;17(8):857–872. doi: 10.1002/(sici)1097-0258(19980430)17:8<857::aid-sim777>3.0.co;2-e
22. Hanley JA, Lippman-Hand А. If nothing goes wrong, is everything alright? JAMA. 1983;249(13):1743–1745. doi: 10.1001/jama.1983.03330370053031
23. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awareness of risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Rus J Prev Med. 2019;22(4):114–123. doi: 10.17116/profmed201922041114
24. Zubko AV, Sabgayda TP, Zemlyanova EV, et al. Social portrait of patients of the cardio-rehabilitation unit of a large cardio-surgical center. Health care of the Russian Federation. 2020;64(3):124–131. doi: 10.46563/0044-197X-2020-64-3-124-131
25. Novikova IA, Khlynova OV, Nekrutenko LA. Risk factors profile for myocardial infarction: focus at a young age. Health Risk Analysis. 2021;3(160–166). doi: 10.21668/health.risk/2021.3.16.eng
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28. Ades PA, Keteyian SJ, Wright JS, et al. Increasing cardiac rehabilitation participation from 20% to 70%: A road map from the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92(2):234–242. doi: 10.1016./j.mayocp.2016.10.014
29. Pack QR, Mansour M, Barboza JS, et al. An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial. Circulation. 2013;127(3):349–355. doi: 10.1161/CIRCULATIOM AHA.112.121996
30. Soroush A, Heydarpour B, Komasi S, et al. Barriers for the referral to outpatient cardiac rehabilitation: A predictive model including actual and perceived risk factors and perceived control. Ann Card Anaesth. 2018;21(3):249–254. doi: 10.4103/aca.ACA_87_17
31. De Vos C, Li X, Vlaenderen I, et al. Participating or not in a cardiac rehabilitation programme: factors influencing a patient’s decision. Eur J Prev Cardiol. 2013;20(2):341–348. doi: 10.1177/2047487312437057
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2. Iliou MC. How can we increase the participation of patients in cardiac rehabilitation programmes? Eur J Prev Cardiol. 2018;25(18):1923–1924. doi: 10.1177/2047487318806698 EDN: ENNSAV
3. Acute myocardial infarction with ST segment elevation electrocardiograms: rehabilitation and secondary prevention. Russian clinical guidelines. CardioSomatica. 2014;S1:5–41. doi: 10.15829/1560-4071-2015-1-6-52
4. O'Gara PT, Kushner FG, Ascheim DD, et al. American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):e362–425. doi: 10.1161/CIR.0b013e3182742cf6
5. Aronov DM. Cardiorehabilitation and secondary prevention. Moscow: GEOTAR‑media, 2021. P. 464. (In Russ.) doi: 10.33029/9704-6218-8-CAR-2021-1-464
6. Bubnova MG. Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs. Cardiovasc Ther Prev. 2020;19(6):2649. doi: 10.15829/1728-8800-2020-2649 EDN: GRLOQC
7. Doimo S, Fabris E, Piepoli M, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. Eur Heart J. 2019;40(8):678–685. doi: 10.1093/eurheartj/ehy417 EDN: NXYVOK
8. Kusunoki S, Maruji A, Kobayashi K, et al. Subjective barriers to adherence to cardiac rehabilitation program after hospital discharge in patients with acute myocardial infarction [in Japanese]. J Jpn Coron Assoc. 2008;14:206–210.
9. Grace S, Chessex C, Arthur H, et al. Systematizing inpatient referral to cardiac rehabilitation 2010: Canadian Association of Cardiac Rehabilitation and Canadian Cardiovascular Society joint position paper. J Cardiopulm Rehabil. 2011;31:E1–E8. doi: 10.1097/HCR.0b013e318219721f
10. Higgins RO, Murphy BM, Goble AJ, et al. Cardiac rehabilitation program attendance after coronary artery bypass surgery: overcoming the barriers. Med J Aust. 2008;188:712–714. doi: 10.5694/j.1326-5377.2008.tb01852.x
11. Mueller E, Savage PD, Schneider DJ, et al. Effect of a computerized referral at hospital discharge on cardiac rehabilitation participation rates. J Cardiopulm Rehabil Prev. 2009;29:365–369. doi: 10.1097/HCR.0b013e3181b4ca75
12. Turk-Adawi KI, Oldridge NB, Tarima SS, et al. Cardiac Rehabilitation Enrollment Among Referred Patients. Ratient and organizational factors. J Cardiopulm Rehabilit Prev. 2014;34:114–122. doi: 10.1097/HCR.0000000000000017
13. Bubnova MG, Novikova NK, Aronov DM. Clinical 16-year Follow-up of patients after acute myocardial infarction: the phenomenon of high commitment to physical rehabilitation. Vestnik vosstanovitelnoi meditsiny. 2016;(4):12–19. EDN: WMQNDN
14. Barbarash Ol, Bezzubova VA, Shibanova IA, Pomeshkina SA. Patients opinion about the necessity of cardiological rehabilitation after coronary shunting. Sibirskoe meditsinskoe obozrenie. 2018;(1):79–82. doi: 10.20333/2500136-2018-1-79-82 EDN: YXPIJQ
15. Pomeshkina SA, Borovik IV, Zavyrylina IN, et al. Adherence to Therapy as a Factor Determining Prognosis of Coronary Artery Bypass Grafting. Kardiologiia. 2015;(5):48–53. DOI:10.18565/cardio.2015.5.48-53.
16. Bubnova MG, Aronov DM, Krasnitsky VB, et al. A home exercise training program after acute coronary syndrome and/or endovascular coronary intervention: efficiency and a patient motivation problem. Terapevticheskiy arkhiv. 2014;86(1):23–32. EDN: RTZPKD
17. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awarenessof risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Preventive Medicine. 2019;22(4):114–123. doi: 10.17116/profmed2019119081114
18. Arnett DK, Blumenthal RS, Albert MA, et al. ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):e177–e232. doi: 10.1016/j.jacc.2019.03.010
19. Martsevich SYu, Zolotareva NP, Zagrebelnyy AV, et al. Refusal of prescribed drug therapy (absolute non-adherence) after acute myocardial infarction/unstable angina: data from prospective observation in the LIS‑3 registry. Rational Pharmacotherapy in Cardiology. 2023;19(6):572–578. DOI:10.20996/1819-6446-2023-2988. EDN: QVNHXA
20. Aronov DM, Bubnova MG, Drapkina OM. Non-pharmacological therapy of patients with cardiovascular diseases in cardiac rehabilitation programs. Russian Journal of Preventive Medicine. 2020;23(6–2):57–64. doi: 10.17116/profmed20202306257
21. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Statistics in Medicine. 1998;17(8):857–872. doi: 10.1002/(sici)1097-0258(19980430)17:8<857::aid-sim777>3.0.co;2-e
22. Hanley JA, Lippman-Hand А. If nothing goes wrong, is everything alright? JAMA. 1983;249(13):1743–1745. doi: 10.1001/jama.1983.03330370053031
23. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awareness of risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Rus J Prev Med. 2019;22(4):114–123. doi: 10.17116/profmed201922041114
24. Zubko AV, Sabgayda TP, Zemlyanova EV, et al. Social portrait of patients of the cardio-rehabilitation unit of a large cardio-surgical center. Health care of the Russian Federation. 2020;64(3):124–131. doi: 10.46563/0044-197X-2020-64-3-124-131
25. Novikova IA, Khlynova OV, Nekrutenko LA. Risk factors profile for myocardial infarction: focus at a young age. Health Risk Analysis. 2021;3(160–166). doi: 10.21668/health.risk/2021.3.16.eng
26. Guryanova EA, Shamitova EN. Efficiency of cardiorehabilitation of patients with acute myocardial infarction after interventions. Modern problems of science and education. 2020;(4):135. doi: 10.17513/spno.30057 EDN: XVSUPO
27. Anderson L, Oldridge N, Thompson DR, et al. Exercise based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016;1:CD001800. doi: 10.1002/14651858.CD001800.pub3
28. Ades PA, Keteyian SJ, Wright JS, et al. Increasing cardiac rehabilitation participation from 20% to 70%: A road map from the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92(2):234–242. doi: 10.1016./j.mayocp.2016.10.014
29. Pack QR, Mansour M, Barboza JS, et al. An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial. Circulation. 2013;127(3):349–355. doi: 10.1161/CIRCULATIOM AHA.112.121996
30. Soroush A, Heydarpour B, Komasi S, et al. Barriers for the referral to outpatient cardiac rehabilitation: A predictive model including actual and perceived risk factors and perceived control. Ann Card Anaesth. 2018;21(3):249–254. doi: 10.4103/aca.ACA_87_17
31. De Vos C, Li X, Vlaenderen I, et al. Participating or not in a cardiac rehabilitation programme: factors influencing a patient’s decision. Eur J Prev Cardiol. 2013;20(2):341–348. doi: 10.1177/2047487312437057
32. Endo N, Goto A, Suzuki T, et al. Factors Associated With Enrollment and Adherence in Outpatient Cardiac Rehabilitation in Japan. J Cardiopulm Rehabil Prev. 2015;35:186–192. doi: 10.1097/HCR.0000000000000103
33. Beatty AL, Fukuoka Y, Whooley MA. Using mobile technology for cardiac rehabilitation: a review and framework for development and evaluation. J Am Heart Assoc. 2013;2(6):e000568. doi: 10.1161/JAHA.113.000568
34. Lyamina NP, Kharytonov SV. Digital wearable devices in cardiac rehabilitation: patient need and satisfaction. Literature Review. Cardiosomatics. 2022;13(1):23–30. EDN: UOYKGE doi: 10.17816/22217185.2022.1.201471
35. Lyamina NP, Somov DA, Sorokina EV, Peresada AK. Effekty programmy domashnikh trenirovok u patsientov, perenesshikh ostryi infarkt miokarda i endovaskulyarnoe vmeshatelstvo. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kultury. 2023;100:(5-2):23. EDN: TQERSV
36. Larina VN, Lunev VI, Fedorova EV, et al. Treatment adherence priorities: Results of an online survey of doctors providing outpatient services. CardioSomatics. 2024;15(3):201–210. doi: 10.17816/CS626967
37. Bustamante MJ, Valentino G, Kramer V, et al. Patient Adherence to a Cardiovascular Rehabilitation Program: What Factors Are Involved? Int J Clin Med. 2015;6:605–614. doi: 10.4236/ijcm.2015.69081
38. Balady GJ, Ades PA, Bittner VA, et al. Referral, Enrollment, and Delivery of Cardiac Rehabilitation/Secondary Prevention Programs at Clinical Centers and Beyond: A Presidential Advisory from the American Heart Association. Circulation. 2011;124(25):2951–2960. doi: 10.1161/CIR.0b013e31823b21e2
2. Iliou MC. How can we increase the participation of patients in cardiac rehabilitation programmes? Eur J Prev Cardiol. 2018;25(18):1923–1924. doi: 10.1177/2047487318806698 EDN: ENNSAV
3. Acute myocardial infarction with ST segment elevation electrocardiograms: rehabilitation and secondary prevention. Russian clinical guidelines. CardioSomatica. 2014;S1:5–41. doi: 10.15829/1560-4071-2015-1-6-52
4. O'Gara PT, Kushner FG, Ascheim DD, et al. American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):e362–425. doi: 10.1161/CIR.0b013e3182742cf6
5. Aronov DM. Cardiorehabilitation and secondary prevention. Moscow: GEOTAR‑media, 2021. P. 464. (In Russ.) doi: 10.33029/9704-6218-8-CAR-2021-1-464
6. Bubnova MG. Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs. Cardiovasc Ther Prev. 2020;19(6):2649. doi: 10.15829/1728-8800-2020-2649 EDN: GRLOQC
7. Doimo S, Fabris E, Piepoli M, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. Eur Heart J. 2019;40(8):678–685. doi: 10.1093/eurheartj/ehy417 EDN: NXYVOK
8. Kusunoki S, Maruji A, Kobayashi K, et al. Subjective barriers to adherence to cardiac rehabilitation program after hospital discharge in patients with acute myocardial infarction [in Japanese]. J Jpn Coron Assoc. 2008;14:206–210.
9. Grace S, Chessex C, Arthur H, et al. Systematizing inpatient referral to cardiac rehabilitation 2010: Canadian Association of Cardiac Rehabilitation and Canadian Cardiovascular Society joint position paper. J Cardiopulm Rehabil. 2011;31:E1–E8. doi: 10.1097/HCR.0b013e318219721f
10. Higgins RO, Murphy BM, Goble AJ, et al. Cardiac rehabilitation program attendance after coronary artery bypass surgery: overcoming the barriers. Med J Aust. 2008;188:712–714. doi: 10.5694/j.1326-5377.2008.tb01852.x
11. Mueller E, Savage PD, Schneider DJ, et al. Effect of a computerized referral at hospital discharge on cardiac rehabilitation participation rates. J Cardiopulm Rehabil Prev. 2009;29:365–369. doi: 10.1097/HCR.0b013e3181b4ca75
12. Turk-Adawi KI, Oldridge NB, Tarima SS, et al. Cardiac Rehabilitation Enrollment Among Referred Patients. Ratient and organizational factors. J Cardiopulm Rehabilit Prev. 2014;34:114–122. doi: 10.1097/HCR.0000000000000017
13. Bubnova MG, Novikova NK, Aronov DM. Clinical 16-year Follow-up of patients after acute myocardial infarction: the phenomenon of high commitment to physical rehabilitation. Vestnik vosstanovitelnoi meditsiny. 2016;(4):12–19. EDN: WMQNDN
14. Barbarash Ol, Bezzubova VA, Shibanova IA, Pomeshkina SA. Patients opinion about the necessity of cardiological rehabilitation after coronary shunting. Sibirskoe meditsinskoe obozrenie. 2018;(1):79–82. doi: 10.20333/2500136-2018-1-79-82 EDN: YXPIJQ
15. Pomeshkina SA, Borovik IV, Zavyrylina IN, et al. Adherence to Therapy as a Factor Determining Prognosis of Coronary Artery Bypass Grafting. Kardiologiia. 2015;(5):48–53. DOI:10.18565/cardio.2015.5.48-53.
16. Bubnova MG, Aronov DM, Krasnitsky VB, et al. A home exercise training program after acute coronary syndrome and/or endovascular coronary intervention: efficiency and a patient motivation problem. Terapevticheskiy arkhiv. 2014;86(1):23–32. EDN: RTZPKD
17. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awarenessof risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Preventive Medicine. 2019;22(4):114–123. doi: 10.17116/profmed2019119081114
18. Arnett DK, Blumenthal RS, Albert MA, et al. ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):e177–e232. doi: 10.1016/j.jacc.2019.03.010
19. Martsevich SYu, Zolotareva NP, Zagrebelnyy AV, et al. Refusal of prescribed drug therapy (absolute non-adherence) after acute myocardial infarction/unstable angina: data from prospective observation in the LIS‑3 registry. Rational Pharmacotherapy in Cardiology. 2023;19(6):572–578. DOI:10.20996/1819-6446-2023-2988. EDN: QVNHXA
20. Aronov DM, Bubnova MG, Drapkina OM. Non-pharmacological therapy of patients with cardiovascular diseases in cardiac rehabilitation programs. Russian Journal of Preventive Medicine. 2020;23(6–2):57–64. doi: 10.17116/profmed20202306257
21. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Statistics in Medicine. 1998;17(8):857–872. doi: 10.1002/(sici)1097-0258(19980430)17:8<857::aid-sim777>3.0.co;2-e
22. Hanley JA, Lippman-Hand А. If nothing goes wrong, is everything alright? JAMA. 1983;249(13):1743–1745. doi: 10.1001/jama.1983.03330370053031
23. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awareness of risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Rus J Prev Med. 2019;22(4):114–123. doi: 10.17116/profmed201922041114
24. Zubko AV, Sabgayda TP, Zemlyanova EV, et al. Social portrait of patients of the cardio-rehabilitation unit of a large cardio-surgical center. Health care of the Russian Federation. 2020;64(3):124–131. doi: 10.46563/0044-197X-2020-64-3-124-131
25. Novikova IA, Khlynova OV, Nekrutenko LA. Risk factors profile for myocardial infarction: focus at a young age. Health Risk Analysis. 2021;3(160–166). doi: 10.21668/health.risk/2021.3.16.eng
26. Guryanova EA, Shamitova EN. Efficiency of cardiorehabilitation of patients with acute myocardial infarction after interventions. Modern problems of science and education. 2020;(4):135. doi: 10.17513/spno.30057 EDN: XVSUPO
27. Anderson L, Oldridge N, Thompson DR, et al. Exercise based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016;1:CD001800. doi: 10.1002/14651858.CD001800.pub3
28. Ades PA, Keteyian SJ, Wright JS, et al. Increasing cardiac rehabilitation participation from 20% to 70%: A road map from the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92(2):234–242. doi: 10.1016./j.mayocp.2016.10.014
29. Pack QR, Mansour M, Barboza JS, et al. An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial. Circulation. 2013;127(3):349–355. doi: 10.1161/CIRCULATIOM AHA.112.121996
30. Soroush A, Heydarpour B, Komasi S, et al. Barriers for the referral to outpatient cardiac rehabilitation: A predictive model including actual and perceived risk factors and perceived control. Ann Card Anaesth. 2018;21(3):249–254. doi: 10.4103/aca.ACA_87_17
31. De Vos C, Li X, Vlaenderen I, et al. Participating or not in a cardiac rehabilitation programme: factors influencing a patient’s decision. Eur J Prev Cardiol. 2013;20(2):341–348. doi: 10.1177/2047487312437057
32. Endo N, Goto A, Suzuki T, et al. Factors Associated With Enrollment and Adherence in Outpatient Cardiac Rehabilitation in Japan. J Cardiopulm Rehabil Prev. 2015;35:186–192. doi: 10.1097/HCR.0000000000000103
33. Beatty AL, Fukuoka Y, Whooley MA. Using mobile technology for cardiac rehabilitation: a review and framework for development and evaluation. J Am Heart Assoc. 2013;2(6):e000568. doi: 10.1161/JAHA.113.000568
34. Lyamina NP, Kharytonov SV. Digital wearable devices in cardiac rehabilitation: patient need and satisfaction. Literature Review. Cardiosomatics. 2022;13(1):23–30. EDN: UOYKGE doi: 10.17816/22217185.2022.1.201471
35. Lyamina NP, Somov DA, Sorokina EV, Peresada AK. Effekty programmy domashnikh trenirovok u patsientov, perenesshikh ostryi infarkt miokarda i endovaskulyarnoe vmeshatelstvo. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kultury. 2023;100:(5-2):23. EDN: TQERSV
36. Larina VN, Lunev VI, Fedorova EV, et al. Treatment adherence priorities: Results of an online survey of doctors providing outpatient services. CardioSomatics. 2024;15(3):201–210. doi: 10.17816/CS626967
37. Bustamante MJ, Valentino G, Kramer V, et al. Patient Adherence to a Cardiovascular Rehabilitation Program: What Factors Are Involved? Int J Clin Med. 2015;6:605–614. doi: 10.4236/ijcm.2015.69081
38. Balady GJ, Ades PA, Bittner VA, et al. Referral, Enrollment, and Delivery of Cardiac Rehabilitation/Secondary Prevention Programs at Clinical Centers and Beyond: A Presidential Advisory from the American Heart Association. Circulation. 2011;124(25):2951–2960. doi: 10.1161/CIR.0b013e31823b21e2
________________________________________________
2. Iliou MC. How can we increase the participation of patients in cardiac rehabilitation programmes? Eur J Prev Cardiol. 2018;25(18):1923–1924. doi: 10.1177/2047487318806698 EDN: ENNSAV
3. Acute myocardial infarction with ST segment elevation electrocardiograms: rehabilitation and secondary prevention. Russian clinical guidelines. CardioSomatica. 2014;S1:5–41. doi: 10.15829/1560-4071-2015-1-6-52
4. O'Gara PT, Kushner FG, Ascheim DD, et al. American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):e362–425. doi: 10.1161/CIR.0b013e3182742cf6
5. Aronov DM. Cardiorehabilitation and secondary prevention. Moscow: GEOTAR‑media, 2021. P. 464. (In Russ.) doi: 10.33029/9704-6218-8-CAR-2021-1-464
6. Bubnova MG. Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs. Cardiovasc Ther Prev. 2020;19(6):2649. doi: 10.15829/1728-8800-2020-2649 EDN: GRLOQC
7. Doimo S, Fabris E, Piepoli M, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. Eur Heart J. 2019;40(8):678–685. doi: 10.1093/eurheartj/ehy417 EDN: NXYVOK
8. Kusunoki S, Maruji A, Kobayashi K, et al. Subjective barriers to adherence to cardiac rehabilitation program after hospital discharge in patients with acute myocardial infarction [in Japanese]. J Jpn Coron Assoc. 2008;14:206–210.
9. Grace S, Chessex C, Arthur H, et al. Systematizing inpatient referral to cardiac rehabilitation 2010: Canadian Association of Cardiac Rehabilitation and Canadian Cardiovascular Society joint position paper. J Cardiopulm Rehabil. 2011;31:E1–E8. doi: 10.1097/HCR.0b013e318219721f
10. Higgins RO, Murphy BM, Goble AJ, et al. Cardiac rehabilitation program attendance after coronary artery bypass surgery: overcoming the barriers. Med J Aust. 2008;188:712–714. doi: 10.5694/j.1326-5377.2008.tb01852.x
11. Mueller E, Savage PD, Schneider DJ, et al. Effect of a computerized referral at hospital discharge on cardiac rehabilitation participation rates. J Cardiopulm Rehabil Prev. 2009;29:365–369. doi: 10.1097/HCR.0b013e3181b4ca75
12. Turk-Adawi KI, Oldridge NB, Tarima SS, et al. Cardiac Rehabilitation Enrollment Among Referred Patients. Ratient and organizational factors. J Cardiopulm Rehabilit Prev. 2014;34:114–122. doi: 10.1097/HCR.0000000000000017
13. Bubnova MG, Novikova NK, Aronov DM. Clinical 16-year Follow-up of patients after acute myocardial infarction: the phenomenon of high commitment to physical rehabilitation. Vestnik vosstanovitelnoi meditsiny. 2016;(4):12–19. EDN: WMQNDN
14. Barbarash Ol, Bezzubova VA, Shibanova IA, Pomeshkina SA. Patients opinion about the necessity of cardiological rehabilitation after coronary shunting. Sibirskoe meditsinskoe obozrenie. 2018;(1):79–82. doi: 10.20333/2500136-2018-1-79-82 EDN: YXPIJQ
15. Pomeshkina SA, Borovik IV, Zavyrylina IN, et al. Adherence to Therapy as a Factor Determining Prognosis of Coronary Artery Bypass Grafting. Kardiologiia. 2015;(5):48–53. DOI:10.18565/cardio.2015.5.48-53.
16. Bubnova MG, Aronov DM, Krasnitsky VB, et al. A home exercise training program after acute coronary syndrome and/or endovascular coronary intervention: efficiency and a patient motivation problem. Terapevticheskiy arkhiv. 2014;86(1):23–32. EDN: RTZPKD
17. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awarenessof risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Preventive Medicine. 2019;22(4):114–123. doi: 10.17116/profmed2019119081114
18. Arnett DK, Blumenthal RS, Albert MA, et al. ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):e177–e232. doi: 10.1016/j.jacc.2019.03.010
19. Martsevich SYu, Zolotareva NP, Zagrebelnyy AV, et al. Refusal of prescribed drug therapy (absolute non-adherence) after acute myocardial infarction/unstable angina: data from prospective observation in the LIS‑3 registry. Rational Pharmacotherapy in Cardiology. 2023;19(6):572–578. DOI:10.20996/1819-6446-2023-2988. EDN: QVNHXA
20. Aronov DM, Bubnova MG, Drapkina OM. Non-pharmacological therapy of patients with cardiovascular diseases in cardiac rehabilitation programs. Russian Journal of Preventive Medicine. 2020;23(6–2):57–64. doi: 10.17116/profmed20202306257
21. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Statistics in Medicine. 1998;17(8):857–872. doi: 10.1002/(sici)1097-0258(19980430)17:8<857::aid-sim777>3.0.co;2-e
22. Hanley JA, Lippman-Hand А. If nothing goes wrong, is everything alright? JAMA. 1983;249(13):1743–1745. doi: 10.1001/jama.1983.03330370053031
23. Bubnova MG, Aronov DM, Novikova NK, et al. Study of awareness of risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience. Rus J Prev Med. 2019;22(4):114–123. doi: 10.17116/profmed201922041114
24. Zubko AV, Sabgayda TP, Zemlyanova EV, et al. Social portrait of patients of the cardio-rehabilitation unit of a large cardio-surgical center. Health care of the Russian Federation. 2020;64(3):124–131. doi: 10.46563/0044-197X-2020-64-3-124-131
25. Novikova IA, Khlynova OV, Nekrutenko LA. Risk factors profile for myocardial infarction: focus at a young age. Health Risk Analysis. 2021;3(160–166). doi: 10.21668/health.risk/2021.3.16.eng
26. Guryanova EA, Shamitova EN. Efficiency of cardiorehabilitation of patients with acute myocardial infarction after interventions. Modern problems of science and education. 2020;(4):135. doi: 10.17513/spno.30057 EDN: XVSUPO
27. Anderson L, Oldridge N, Thompson DR, et al. Exercise based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016;1:CD001800. doi: 10.1002/14651858.CD001800.pub3
28. Ades PA, Keteyian SJ, Wright JS, et al. Increasing cardiac rehabilitation participation from 20% to 70%: A road map from the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92(2):234–242. doi: 10.1016./j.mayocp.2016.10.014
29. Pack QR, Mansour M, Barboza JS, et al. An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial. Circulation. 2013;127(3):349–355. doi: 10.1161/CIRCULATIOM AHA.112.121996
30. Soroush A, Heydarpour B, Komasi S, et al. Barriers for the referral to outpatient cardiac rehabilitation: A predictive model including actual and perceived risk factors and perceived control. Ann Card Anaesth. 2018;21(3):249–254. doi: 10.4103/aca.ACA_87_17
31. De Vos C, Li X, Vlaenderen I, et al. Participating or not in a cardiac rehabilitation programme: factors influencing a patient’s decision. Eur J Prev Cardiol. 2013;20(2):341–348. doi: 10.1177/2047487312437057
32. Endo N, Goto A, Suzuki T, et al. Factors Associated With Enrollment and Adherence in Outpatient Cardiac Rehabilitation in Japan. J Cardiopulm Rehabil Prev. 2015;35:186–192. doi: 10.1097/HCR.0000000000000103
33. Beatty AL, Fukuoka Y, Whooley MA. Using mobile technology for cardiac rehabilitation: a review and framework for development and evaluation. J Am Heart Assoc. 2013;2(6):e000568. doi: 10.1161/JAHA.113.000568
34. Lyamina NP, Kharytonov SV. Digital wearable devices in cardiac rehabilitation: patient need and satisfaction. Literature Review. Cardiosomatics. 2022;13(1):23–30. EDN: UOYKGE doi: 10.17816/22217185.2022.1.201471
35. Lyamina NP, Somov DA, Sorokina EV, Peresada AK. Effekty programmy domashnikh trenirovok u patsientov, perenesshikh ostryi infarkt miokarda i endovaskulyarnoe vmeshatelstvo. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kultury. 2023;100:(5-2):23. EDN: TQERSV
36. Larina VN, Lunev VI, Fedorova EV, et al. Treatment adherence priorities: Results of an online survey of doctors providing outpatient services. CardioSomatics. 2024;15(3):201–210. doi: 10.17816/CS626967
37. Bustamante MJ, Valentino G, Kramer V, et al. Patient Adherence to a Cardiovascular Rehabilitation Program: What Factors Are Involved? Int J Clin Med. 2015;6:605–614. doi: 10.4236/ijcm.2015.69081
38. Balady GJ, Ades PA, Bittner VA, et al. Referral, Enrollment, and Delivery of Cardiac Rehabilitation/Secondary Prevention Programs at Clinical Centers and Beyond: A Presidential Advisory from the American Heart Association. Circulation. 2011;124(25):2951–2960. doi: 10.1161/CIR.0b013e31823b21e2
Авторы
С.Е. Головенкин*1, С.Ю. Никулина1, М.Г. Бубнова2, И.В. Савицкий1
1Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого, Красноярск, Россия;
2Национальный медицинский исследовательский центр терапии и профилактической медицины, Москва, Россия
*gse2008@mail.ru
1Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia;
2National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
*gse2008@mail.ru
1Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого, Красноярск, Россия;
2Национальный медицинский исследовательский центр терапии и профилактической медицины, Москва, Россия
*gse2008@mail.ru
________________________________________________
1Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia;
2National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
*gse2008@mail.ru
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