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Heart attack rehab may work via phone or Internet

June 17, 2009 | 12:19 pm

Heart attack patients may not always need to see their doctors face to face to get good rehab care. Online updates of their progress may work just as well.

In a study published in the European Society of Cardiology Tuesday, Australian researchers found that electronic communication with a healthcare provider could have similar life-saving effects to the more traditional in-person cardiac rehabilitation programs.

The scientists examined prevention programs in which at least half of the contact between healthcare providers and their patients took place through telephone, Internet or videoconferencing. They compared these patients with similar people who received no intervention, examining cholesterol levels, blood pressure, weight, physical activity, physical and psychological quality of life and smoking status.

Patients who received care electronically had significantly reduced risk factors and increased quality of life compared with the control, nonintervention groups. They lost weight, exercised more, smoked less, and had lower blood pressure and cholesterol levels.

The only factor that did not measurably improve with intervention was mental health. This was not necessarily due to a stagnant mental status, however: Heart attack patients tend to experience an improvement in mood with the passage of time even without intervention, says study co-author Julie Redfern, of the ANZAC Research Institute in Sydney, Australia.

It's well-known that formal, face-to-face, 6- to 8-week programs in which patients are given education and counseling on practices such as nutrition and physical activity, along with exercise classes, consistently reduce the risk of further cardiac events and enhance patients' quality of life. But in Europe, Australia and the United States, only one-third of eligible patients attend such sessions. 

It’s also known that heart attack patients who do not attend such programs have higher mortality rates, and those who do manage to make it to meetings face rigid structure and time constraints. Perhaps for that reason, the drop-out rate is high: about one-third of patients who start rehab don't complete the program.

Electronic communication tends to be more frequent, flexible and individualized, which improves ease of access and removes the barriers of distance and time, Redfern says.  And, she adds, it's possible -- though not proven -- that this type of communication may turn out to be less expensive as well.

-- Shara Yurkiewicz