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Effect of the patient education -- learning and coping strategies -- in cardiac rehabilitation on return to work at one year: a randomised controlled trial show (LC-REHAB)
Bitsch BL, Nielsen CV, Stapelfeldt CM, Lynggaard V
BMC Cardiovascular Disorders 2018 May 21;18(101):Epub
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Personal resources are identified as important for the ability to return to work (RTW) for patients with ischaemic heart disease (IHD) or heart failure (HF) undergoing cardiac rehabilitation (CR). The patient education 'learning and coping' (LC) addresses personal resources through a pedagogical approach. This trial aimed to assess effect of adding LC strategies in CR compared to standard CR measured on RTW status at one-year follow-up after CR. METHODS: In an open parallel randomised controlled trial, patients with IHD or HF were block-randomised in a 1:1 ratio to the LC arm (LC plus CR) or the control arm (CR alone) across three Danish hospital units. Eligible patients were aged 18 to <= 60 and had not left the labour market. The intervention was developed from an inductive pedagogical approach consisting of individual interviews and group based teaching by health professionals with experienced patients as co-educators. The control arm consisted of deductive teaching (standard CR). RTW status was derived from the Danish Register for Evaluation of Marginalisation (DREAM). Blinding was not possible. The effect was evaluated by logistic regression analysis and reported as crude and adjusted odds ratios (OR) with 95% confidence interval (CI). RESULTS: The population for the present analysis was n = 244 (LC arm n = 119 versus control arm n = 125). No difference in RTW status was found at one year across arms (LC arm 64.7% versus control arm 68.8%, adjusted odds ratio OR 0.76, 95% CI 0.43 to 1.31). CONCLUSION: Addition of LC strategies in CR showed no improvement in RTW at one year follow-up. TRIAL REGISTRATION: www.ClinicalTrials.gov identifier NCT01668394.

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