Coronary Artery Disease Clinical Trial
Official title:
A Randomized Controlled Trial of Women's Adherence to Women-only, Home-based and Traditional Cardiac Rehabilitation (Cardiac Rehabilitation for Her Heart Event Recovery [CR4HER])
The purpose of this study is to compare women's cardiac rehabilitation program adherence across three program models.
Heart disease is the leading cause of morbidity and mortality for women in Canada. Cardiac
rehabilitation (CR) is an outpatient secondary prevention program composed of structured
exercise and comprehensive education and counseling. CR participation results in lower
morbidity and mortality, among other benefits. Unfortunately, women are significantly less
likely to adhere to these programs than men. While the traditional model of CR care is a
hospital-based mixed-sex program, women are the minority in such programs, and state that
these programs do not meet their care preferences. Two other models of CR care have been
developed: hospital-based women-only (sex-specific) and monitored home-based programs. Other
than through our controlled pilot testing of 36 patients, women's adherence to these program
models is not well known.
CR4HER is a 3 parallel arm pragmatic RCT designed to compare program adherence to
traditional hospital-based CR with males and females, home-based CR, and women-only
hospital-based CR. Power calculations based on our pilot study suggest a sample size of 261
patients is needed to detect a difference in adherence by program model using ANCOVA.
Participants are female CAD, acute coronary syndrome, percutaneous coronary intervention,
bypass surgery, or valve surgery inpatients recruited from 5 hospitals. Also, female
patients referred to participating cardiac rehabilitation (3) centres with one of the
aforementioned diagnosis will be approached to participate. The primary outcome variable is
program adherence operationalized as CR site-reported percentage of prescribed sessions
completed by phone or on-site, as reported by a staff member who is blind to study
objectives. Secondary outcomes are exercise capacity operationalized as VO2peak on a graded
stress test, and exercise, dietary, smoking and medication adherence behaviours measured in
hospital and 1 week post-CR. By identifying the CR program model which results in the
greatest adherence for women, we can optimize their participation and potentially their
cardiac outcomes.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research
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