In 2007, a Community based Cardiac Rehabilitation (CR) Program (Community Cardiovascular Hearts in Motion – CCHIM) was developed as a research project, and was designed to go beyond the walls of tertiary care and beyond coronary artery disease alone.The 12 week program is offered to ALL patients at high risk for (Primary Prevention) and with established (Secondary Prevention) cardiovascular disease populations, (Post heart attack, Stroke or established peripheral vascular disease) using a behavior change model that is applied by all team members.
This single team, made up of dieticians, nurses and physiotherapists, manages three sites throughout the Capital Health Community. Program referral is focused on the Family Doctor as opposed to the traditional methods of CR referral (from the hospital and specialists). Our goal was to prove that aggressive intervention across the entire atherosclerotic population would decrease the risk of major Atherosclerotic events by both sustained lifestyle change and risk factor reduction.
The team works with the patient to develop individualized exercise prescriptions and nutrition interventions with self-selected goals for health improvement. Patients then complete a 12 week multi-risk and polyvascular prevention program, after which they are followed up at six and 12 months intervals upon program completion. Patients are assessed to determine if the improvements made during the program are longstanding and health benefits are gained. All patients entering the program are encouraged to bring along a family member to help understand patient centered issues and to help the patient achieve their goals.
The goals of this program are to measurably change the level of risk and the clinical outcomes in patients who are at risk for or already have established cardiovascular disease. There are a number of measurement tools in place to determine patient risk factors. Overall Key Patient Outcome results at Hearts in Motion include:
- 60% of patients with diabetes achieve A1c <7% after completing Hearts in Motion program
- Blood Pressure Reduction for all patients with >80% achieving BP target range
- LDL – cholesterol Lowering at 1 year for all patients with > 68% “at target” for LDL
- More than 11% of patients eliminate obesity as a risk factor
- 50% improvement in Eating Stage Scores for Fibre, Fat & Calories
- 33% reduction in anxiety and 29% decreased depression for both Stroke and Heart Disease patients as measured by HADS (Hospital Anxiety Depression Score) (all are significant at p<0.0001 relative to baseline).
Community Cardiovascular Hearts in Motion programs have evolved from the research platform, and with ‘KT in Motion’, we will continue to take every opportunity to improve cardiovascular risk throughout NS with significant impact on health care and its costs.