Panminerva medica
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Since CR was introduced, studies have been carried out to discover the effect of CRHPs on cardiovascular morbidity and mortality and on heart-disease patients' quality of life. The first meta-analyses showed improvement in cardiovascular morbidity and mortality, although the studies were conducted in the coronary pre-reperfusion era, before the generalized use in secondary prevention of drugs such as statins, beta-blockers, or renin-angiotensin-system inhibitors, which have produced a decrease in cardiovascular mortality. In Europe, analyzing 25 studies with more than 200,000 patients. ⋯ Compared to the usual treatments in cardiology, the patients who underwent CRHPs presented fewer readmissions for cardiovascular reasons (17% vs. 43.38%, P<0.001), fewer major cardiovascular events (11.9% vs. 27.2%, P<0.001) and new revascularizations (9.3% vs. 21.32%, P=0.001), with lower cardiovascular mortality (0 vs. 2.2%, P=0.014). It also led to better control of the RFCV (66% vs. 19.85%, P<0.001) and favored lifestyle changes in these patients (91% vs. 61%, P<0.001). Therefore, in our setting, the performance of CRHPs was shown to be effective in reducing cardiovascular morbidity and mortality and in the secondary prevention of coronary patients.
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Cardiac rehabilitation (CR) has pioneered using multidisciplinary teams to attend all aspects of a patient's illness with high levels of professionalism and quality, providing individualized treatment, and negotiating any changes in lifestyle and treatment course. Clinical management transfers the management capacity to professionals, thus avoiding any increase in costs and healthcare spending, which can result in quality losses and less social legitimacy. Modern CR has been configured as the most effective comprehensive cardiovascular prevention strategy and given its preventive nature it must be a part of all cardiovascular health-related processes as a sub-process. ⋯ Its improvement allows for better rationalization of resources, reduces costs, and offers safer care focused on the needs of the patient. The definition of the technical competencies of the different professionals (functions of the members of the CR unit) is a necessity both from the point of view of its teaching utility, and from planning and management of health services. For a CR team able to carry out clinical management by the quality and safety processes, it needs members who possess professionalism, leadership, adequate communication, adequate training and knowledge management.