Research

Cardiac rehabilitation in Austria: long term health-related quality of life outcomes

Stefan Höfer¹ , Werner Kullich² , Ursula Graninger³ , Manfred Wonisch⁴ , Alfred Gaßner⁵ , Martin Klicpera⁶ , Herbert Laimer⁷ , Christiane Marko⁸ , Helmut Schwann⁹ and Rudolf Müller³

¹  Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria

²  Ludwig-Boltzmann-Cluster, Institute for Rehabilitation, Saalfelden, Austria

³  Austrian Pension Insurance Institution, Pensionsversicherungsanstalt, Vienna, Austria

⁴  Center for Cardiac Rehabilitation, St. Radegund, Austria

⁵  Center for Cardiac Rehabilitation, Großgmain, Austria

⁶  Center for Cardiac Rehabilitation, Hochegg, Austria

⁷  Center for Cardiac Rehabilitation, Bad Tatzmannsdorf, Austria

⁸  Center for Cardiac Rehabilitation, Felbring, Austria

⁹  Center for Cardiac Rehabilitation, Saalfelden, Austria

author email corresponding author email

Health and Quality of Life Outcomes 2009, 7:99doi:10.1186/1477-7525-7-99

Published:	8 December 2009

Abstract

Background

The goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.

Methods

Patients (N = 487, 64.7% male, age 60.9 ± 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].

Results

All MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.

Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.

Conclusion

These findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.