{"id":138279,"date":"2024-04-08T08:53:33","date_gmt":"2024-04-08T12:53:33","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138279"},"modified":"2024-04-08T08:53:33","modified_gmt":"2024-04-08T12:53:33","slug":"help-behavioral-interventions-improve-cardiac-rehabilitation-attendance-among-recently-hospitalized-patients-with-lower-ses","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138279","title":{"rendered":"HeLP: Behavioral interventions improve cardiac rehabilitation attendance among recently hospitalized patients with lower SES"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Key Points:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low-SES patients are less likely to attend CR following hospitalization for a major cardiovascular event and are more likely to be readmitted compared to those with higher SES.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The HeLP study found that low-SES adults who were randomized to weekly calls from a case manager, financial incentives, or both had higher rates of post-discharge CR attendance compared to usual care.<\/span><\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Patients with lower socioeconomic status (SES) are more likely to be readmitted following a major cardiac event.\u00a0 While cardiac rehabilitation (CR) has been shown to reduce this risk, patients who are socioeconomically disadvantaged are less likely to attend these programs.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">On April 7, 2024, the principal results of the \u201cIncentives and Case Management to Improve Cardiac Care: the Healthy Lifestyle Program (HeLP)\u201d were presented at ACC Scientific Sessions 2024.\u00a0 The purpose of this study was to compare the efficacy of a care management protocol, financial incentives, or both in improving CR attendance compared to usual care among low-SES adults following recent cardiovascular hospitalization.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">This trial randomized CR-eligible low-SES adults admitted to the hospital for a major cardiovascular condition in a 3:3:3:2 fashion to the intervention arms or usual care.\u00a0 The case management protocol started in the hospital with an in-depth needs assessment followed by weekly standing phone calls. \u00a0 The financial incentive started at a $20 baseline and was increased by $2 for every session attended, with a reset back to baseline for unexcused absences. The combination arm received both interventions.\u00a0 The primary outcome was CR attendance rates.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Of the 314 assessed patients, 2019 were randomized and 192 included in the analysis (8% withdrawal rate).\u00a0 Overall, the average age was 58 and 35% were female.\u00a0 The population had multiple markers of elevated risk, including high rates of prior cardiac hospitalization, current smoking, and low educational attainment.\u00a0 The most common reasons for admission were coronary revascularization (71%), valvular intervention (12%), and heart failure (11%).\u00a0 Those randomized to the intervention arms had significantly higher CR attendance rates than usual care.\u00a0 The combination arm had the highest rates of completion of 30 CR sessions (62%), followed by the incentive arm (42%), case management arm (25%), and usual care (11%) (p&lt;0.001 for trend).\u00a0 Limitations of this study include lack of clinical or functional endpoints.\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Diann Gaalema, PhD, of University of Texas concluded: \u201cThese interventions, especially in combination, can significantly improve CR attendance.\u00a0 Larger trials are required to test the effect of increased attendance on outcomes.\u201d\u00a0\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Points: Low-SES patients are less likely to attend CR following hospitalization for a major cardiovascular event and are more likely to be readmitted compared to those with higher SES. The HeLP study found that low-SES adults who were randomized to weekly calls from a case manager, financial incentives, or both had higher rates of [&hellip;]<\/p>\n","protected":false},"author":40603,"featured_media":138280,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[888,8],"tags":[889,45,47,185],"ppma_author":[1029],"class_list":{"0":"post-138279","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-acc-2024","8":"category-news","9":"tag-acc-2024","10":"tag-conference","11":"tag-featured","12":"tag-news","13":"author-leah-kosyakovsky"},"authors":[{"term_id":1029,"user_id":40603,"is_guest":0,"slug":"leah-kosyakovsky","display_name":"Leah Kosyakovsky","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/864bde69f6f1f80e91e4a97f0a0ba8daa64c2bb702be09ed787444c7dfa045bb?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138279","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40603"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138279"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138279\/revisions"}],"predecessor-version":[{"id":138281,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138279\/revisions\/138281"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/138280"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138279"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138279"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138279"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138279"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}