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Rev Sep 2003
Cardiac Rehabilitation
Best Medicine for your patientswith Coronary Artery Disease
Why you should write thePrescription
TODAY!
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Mission of Cardiac Rehab
To restore and maintain an individuals
optimal physiological, psychological,
social and vocational status.
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Core Program Components
Risk factor management
Baseline & ongoing patient assessment
Exercise/activity training
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What is Cardiac
Rehabilitation? Medically supervised
Lifestyle modification
Monitored progressive exercise/activity
Inpatient-Outpatient-Maintenance (Phase I, II, III)
Individualized, typically 3x/week, up to 12 weeks
Physician Referral Required
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DiseaseManagement
Components Population Identification processes
Evidence-based practice guidelines
Collaborative practice models
Patient self-management education
Process and outcomes measurement, evaluation,
and management
Routine reporting/feedback loop
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What Diagnoses are
Covered?
Medicare Guidelines: Stable Angina
Myocardial Infarction
Coronary Artery Bypass Graft
Private insurance coverage may vary
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Utilization Benefits:
Reduced risk of fatal MI (
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Physician Benefits:
Partnership in case management provides:
Enhanced access to physician services
Consistent surveillance for improved clinical outcomes
Improved patient satisfaction
Patient education for self directed care
Feedback on medications, exercise response and otherappropriate issues
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Patient Benefits:
Improved functional capacity
Increased knowledge of heart disease Improved adherence to positive lifestyle changes
Better compliance with medical regime
Increased self-esteem and confidence
Reduced subsequent morbidity & mortality r/t CAD
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Lifestyle Benefits:
Risk Factor and Lifestyle Modification
Smoking cessation Lipid improvement
Blood pressure control
Exercise guidance
Weight management
Diabetes control
Stress management
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Significant Statistics
Cardiovascular disease accounts for almost 50% of alldeaths in the U.S.
Cardiovascular disease affects 13.5 million Americanseach year
Nearly 1.5 million Americans sustain myocardialinfarctions each year
American Heart Association, Dallas Texas
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Risk Factors
Tobacco
Smoking and Chew
50% decreased risk of CHD 1 year after cessation
Hypertension
90% middle-aged Americans will develop HTN 35 million office visits/yr for HTN
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Risk Factors
Hyperlipidemia
105,000,000 people with a tot chol > 200
10% reduction in TC = 30% reduction in incidence ofCAD
Physical Inactivity $76 billion
> 60% of Americans dont get sufficient exercise
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Exercise Research
Direct relation between inactivity and cardiovascularmortality. Inactivity is an independent risk factor forof CAD.
Exercise capacity is a more powerful predictor ofmortality among men than other established riskfactors for CAD.
Physical fitness has been clearly associated withimprovements in lipid profiles.
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Medical Research
Cardiac Rehab Professionals remain educated on
the latest medical research
New information is presented to your patients,
so they can make informed decisions with you,
their physician
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Cost-effectiveness/
Cost-efficiencyMedicare payments in hospital for CVD in 1997
was $26.9 billion!
Studies, adjusted for quality of life, show savings
of $4,950-$9,200 per year of life saved.
Reduction in re-hospitalizations and medical costs
are well documented.
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Cardiac Rehab Professionals
Partners in Patient Care:
Medical Director
Referring Physician Registered Nurses
Exercise Physiologists
Dieticians/Nutritionists
Social Services/Psychosocial
Pharmacists
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Who can Refer a Patient?
Site-specific Policy:
Cardiologist
Primary Care Physician
Internist
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Communication with Rehab?
Collaborative Approach:
Initial referral/plan of care
Periodic Progress reports
Program oversight by Medical Director
Open ended lines of communication
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Cardiac Rehab adds Value
Cardiac patients have many disease processesand lifestyle concerns that have contributed totheir heart disease.
Cardiac rehab serves the needs of each cardiacpatient and works toward secondary prevention.
Cardiac rehab adds VALUE to your patient careand increases QUALITY OF LIFE!
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CARDIAC REHABILITATION:
A REFERRAL IS APHONE CALL
AWAY!
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