[A multicenter intervention study on referral to cardiac rehabilitation after coronary artery bypass graft surgery: a 1-year follow-up of rehabilitation rates among USSR-born and veteran Israeli patients].
Gendler Y., Geulayov G., Ziv A., Novikov I., Dankner R., Multi-Center Cardiac Rehabilitation Israeli Working Group None.
BACKGROUND: Despite evidence on the benefits of participating in cardiac-rehabilitation (CR) following coronary artery bypass graft (CABG) surgery and the inclusion of CR in the basic "Health Basket", referral and uptake of CR in Israel remain low. OBJECTIVES: To assess the CR participation rate and CR-related outcomes 1-year following CABG-surgery among patients born in the former Soviet Union and veteran-Israelis. METHODOLOGY: An interventional trial was conducted in which 489 and 472 CABG patients from 5 cardiothoracic wards across Israel were interviewed in hospital before surgery, and at home a year later for the control arm and the intervention arm respectively. The intervention included dissemination of information on CR to medical staff and patients. FINDINGS: USSR-born patients constituted 22.5% of the sample. They were one year older than veteran-Israelis (median-age: 68 and 67 years, respectively, p = 0.2), had a larger proportion of women (31.5% vs. 22.4% respectively, p = 0.006), and a larger proportion of widows (20.0% vs. 13.6%, respectively, p = 0.02). Following the intervention, the CR participation rate of veteran-Israeli males increased from 24.6% to 40.4% (p < 0.001), and that of USSR-born males increased from 3.7% to 13.4% (p = 0.037). No USSR-born female participated in CR, while participation rates of veteran-Israeli females increased from 14.6% to 26.9%, p = 0.056. CR participants reported better health-related quality of life and higher levels of cardio-respiratory fitness (p < 0.001) at follow-up, compared to patients who did not participate in CR. CONCLUSION: The intervention was effective in increasing the participation in CR programs among all but USSR-born females. Further research is needed to assess the needs of this subgroup and develop effective interventions.