Cardiac rehabilitation is an individual adapted multidisciplinary intervention for people suffering from Heart Disease. It involves; * Dietary counseling, * Exercise training, * Psychosocial support, * Physician * smoking cessation * Patient education The purpose is quick and complete recovery and to reduce the chance of recurrence. In Denmark people admitted with Acute Cardiac Disease is referred to a course of hospital based cardiac rehabilitation at discharge. The Danish Municipal Reform of 2007 changed the responsibility of rehabilitation from the Regions, who runs the hospitals, to the municipalities. Shared care is in this setting that elements of treatment are completed different places in Health Care. The aim of this study is: * to establish a shared care model for Cardiac rehabilitation following admission with Acute Coronary Syndrome and * to compare this model to the existing hospital based cardiac rehabilitation after admission with Acute Coronary Syndrome. Primary outcome is participation in cardiac rehabilitation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
212
* First visit at cardiac ambulatory approximately 14 days after discharge includes physician examination by cardiologist and counseling from nurse specialized in cardiac rehabilitation. * Dietary counseling with dietician * Exercise (1 hour, 2 timer pr week for 12 weeks) * Smoking cessation if smoker with educated smoking cessation instructor * Patient education and psychosocial support in 2 individual consultations and 8 group based consultations with experienced nurse * Examination by the patient´s general practitioner 8-12 weeks after discharge.
Silkeborg Hospital
Silkeborg, Region Midt, Denmark
Aarhus University Hospital. Department of Cardiology and Medicine
Aarhus, Denmark
Viborg Hospital, Hospital Unit of Viborg, Silkeborg, Hammel and Skive
Viborg, Denmark
Participation in cardiac rehabilitation
Participation in cardiac rehabilitation is evaluated for each element. Participation is defined as at least 50% for each element. * Smoking cessation * Dietary counseling * Exercise training * Physician * Patient education * Psychosocial support Full participation is in 6 of 6 elements if smoker or 5/5 if non-smoker. Partial full participation is in 5/6 if smoker or 4/5 if non-smoker.
Time frame: 4 months
Change of BMI and / or abdominal circumference
Time frame: 4 and 12 months
24-hour Ambulatory Blood Pressure
Time frame: 4 og 12 months
Blood Cholesterol values (Total, LDL, HDL)
Time frame: 4 and 12 months
Fasting Blood glucose
Time frame: 4 and 12 months
Exercise Capacity
Time frame: 4 and 12 months
Lifestyle changes
Diet, Physical Activity, Smoking, Alcohol consumption.
Time frame: 4 and 12 months
Depression score
Estimated by Hospital Anxiety and Depression Scale
Time frame: 4 and 12 months
Compliance to pharmaceutical treatment
Time frame: 4 and 12 months
Readmission
Total and cardiovascular
Time frame: 4 and 12 months
Change in Health Related Quality of Living
SF-12 HeartQoL EQ-5D
Time frame: 4 and 12 months
Difference in Health economic costs
Time frame: 4 and 12 months
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