Eli's Rehab Report

Published on Wed Feb 10, 2010 PDF

Relationship between cardiac rehabilitation and longterm risks of death and myocardial infarction among elderly Medicare beneficiaries. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Circulation. 2010 Jan 5;121(1):63-70. Epub 2009 Dec 21.

If you're on the fence about recommending (or providing) cardiac rehab, new research from the Duke Clinical Research Institute's Center for Clinical and Genetic Economics gives you a green light.

Researchers knew that exercise-based cardiac rehab improves survival rates for patients with coronary heart disease and combats risk factors. Their goal, however, was to find the relationship between the number of cardiac rehab sessions patients attended and long-term outcomes.

Researchers took a national 5 percent sample of Medicare beneficiaries and identified 30,161 elderly patients whose claims revealed they attended at least one outpatient cardiac rehab session between Jan. 1, 2000, and Dec. 31, 2005. Subjects were predominantly white and male, and about 60 percent of them were attending cardiac rehab after a coronary artery bypass graft and about 20 percent after a myocardial infarction (MI).

Findings: After adjusting for demographic characteristics, comorbid conditions, and subsequent hospitalization, researchers found that patients who attended 36 sessions had a 14 percent lower risk of death and a 12 percent lower risk of MI than those who attended 24 sessions. Results also revealed a 22 percent lower risk of death and a 23 percent lower risk of MI than those who attended 12 sessions and a 47 percent lower risk of death and a 31 percent lower risk of MI than those who attended 1 session.

Researchers concluded that among Medicare beneficiaries, a strong dose-response relationship existed between the number of cardiac rehabilitation sessions and long-term outcomes. Attending all 36 sessions reimbursed by Medicare was associated with lower risks of death and MI at 4 years compared with attending fewer sessions.

Food for thought: "Beyond finding that more cardiac rehabilitation is better than less, we saw that relatively few  people who attend any rehab actually seem to utilize their entire Medicare benefit," said the study's lead author Bradley G. Hammill, in PT Bulletin Online's review of the research.

So, you might encourage your patients to use their full benefit, as doing so may improve their longevity, according to this research.