Birgitte Laier Bitsch; Claus Vinther Nielsen; Christina Malmose Stapelfeldt; Vibeke Lynggaard
Effect of the patient education - Learning and Coping strategies - in cardiac rehabilitation on return to work at one year: arandomised controlled trial show (LC-REHAB)
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) addressespersonal resources through a pedagogical approach. This trial aimed to assess effect of adding LC strategies in CR comparedto 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 hadnot left the labour market. The intervention was developed from an inductive pedagogical approach consisting of individualinterviews and group based teaching by health professionals with experienced patients as co-educators. The control armconsisted of deductive teaching (standard CR). RTW status was derived from the Danish Register for Evaluation ofMarginalisation (DREAM). Blinding was not possible. The effect was evaluated by logistic regression analysis and reported ascrude 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 RTWstatus was found at one year across arms (LC arm: 64.7% versus control arm: 68.8%, adjusted odds ratio OR: 0.76, 95% CI:0.43-1.31).
Conclusion
Addition of LC strategies in CR showed no improvement in RTW at one year follow-up.