Document Detail

Poor implementation of cardiac rehabilitation despite broad dissemination of coronary interventions for acute myocardial infarction in Japan: a nationwide survey.
MedLine Citation:
PMID:  17251662     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The implementation of cardiac rehabilitation (CR) after acute myocardial infarction (AMI) has not been fully investigated in Japan, so a nationwide survey of hospitals was conducted. METHODS AND RESULTS: Questionnaires were sent in 2004 to a total of 1,875 hospitals in Japan, including all the 859 Japanese Circulation Society (JCS)-authorized cardiology-training hospitals (THs), 311 JCS-associated hospitals (AH), and 705 randomly sampled non-THs (NTHs). The response rate was 59% (1,106/1,875). The percentages of hospitals treating hospitalized AMI patients were 97% in 526 TH, 85% in 194 AH, and 20% in 339 NTH. Although the rates of implementation of emergency percutaneous coronary intervention were very high (92%, 56%, and 4%, respectively), the rates of implementation of recovery phase CR were low (20%, 8%, and 2%, respectively). In addition, patient education programs (23%, 13% and 2%) and formulated exercise prescriptions based on exercise testing (16%, 7% and 1%) were poorly implemented. More importantly, only 9%, 2% and 0% of these hospitals had outpatient CR programs. From these data, the nationwide participation rate in outpatient CR after AMI in Japan was estimated to be only 3.8-7.6%. CONCLUSION: This first nationwide survey demonstrated that, in contrast to the broad dissemination of acute phase invasive treatment for AMI, the implementation of recovery phase CR, especially outpatient CR, is extremely poor in Japan. In addition, patient education programs and exercise prescription based on exercise testing are only poorly implemented.
Yoichi Goto; Muneyasu Saito; Toshiji Iwasaka; Hiroyuki Daida; Masahiro Kohzuki; Kenji Ueshima; Shigeru Makita; Hitoshi Adachi; Hiroyoshi Yokoi; Kazuto Omiya; Hiroshi Mikouchi; Hiroyuki Yokoyama;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  71     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-25     Completed Date:  2007-04-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  173-9     Citation Subset:  IM    
Division of Cardiology, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Ambulatory Care / statistics & numerical data,  trends
Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data,  trends
Exercise Therapy / statistics & numerical data,  trends
Health Plan Implementation / statistics & numerical data,  utilization*
Health Surveys
Myocardial Infarction / rehabilitation*,  therapy
Patient Education as Topic / statistics & numerical data,  trends*

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