Short- and long-term effects of the patient education strategy—learning and coping—in cardiac rehabilitation: a randomized controlled trial (LC-REHAB).

The objectives were to assess the short- and long-term effect of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on health-related quality of life, patient education impact, cardiac risk factors and lifestyle. In total, 825 patients hospitalized with ischaemic heart disease or heart failure were randomized to either LC-CR or standard CR at three Danish hospitals. Teaching approach in LC-CR was situational, inductive and reflective, with experienced patients as co-educators and supplemental interviews. Teaching approach in standard CR was structured and deductive. Outcomes were assessed immediately after CR, and after 3 months (short term), and after 3 years (long term). Between-arm differences in favour of LC-CR were SF-12 'role emotional' (3.7, 95% CI: 0.6–6.8) and MDI depression score (0.9, 0.1–1.8) immediately after CR, exercise capacity (4 W, 1–9) at 3 months and SF-12 'role physical' (4.6, 0.1–9.0) (long term). Between-arm differences in favour of controls were waist circumference (−1.7 cm, −2.3 to −1.0) immediately after CR and HeiQ domain 'Constructive attitudes and approaches' (0.11, 0.04–0.18), triglycerides (−0.12 mmol/l, −0.21 to −0.02), systolic blood pressure (−3.12 mmHg, −5.66 to −0.58) at 3 months. Adding LC strategies to CR provides inconsistent short-term results but improves 'role physical' long term. [ABSTRACT FROM AUTHOR]