Argument for Coverage of Cardiac Rehab, Counseling for Stable CHF
Improved clinical outcomes, reduction in heart failure-related hospitalizations with counseling
THURSDAY, Nov. 7 (HealthDay News) -- Cardiac rehabilitation (CR) exercise training and chronic heart failure self-care counseling provide significant clinical benefits to individuals with stable chronic heart failure, according to a review published Oct. 30 in the Journal of the American College of Cardiology: Heart Failure.
Philip A. Ades, M.D., from the University of Vermont College of Medicine in Burlington, and colleagues reviewed current evidence on the benefits and risks of CR exercise training and self-care counseling in patients with chronic heart failure.
The researchers identified consistent improvements in chronic heart failure symptoms in addition to reductions in cardiac mortality and the number of hospitalizations in systematic reviews and meta-analyses of CR exercise training alone (without counseling). However, individual trials have been less conclusive regarding reductions in cardiac mortality and hospitalizations. The Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training, the largest single trial, showed a reduction in the adjusted risk for the combined end point of all-cause mortality or hospitalization (hazard ratio: 0.89; P = 0.03) as well as improvements in quality of life and mental depression. Clinical outcomes were improved and chronic heart failure-related hospitalizations reduced with chronic heart failure-related counseling, whether provided in isolation or in combination with CR exercise training.
"Third-party payers should provide medical insurance coverage for supervised CR for appropriately-selected patients with stable chronic heart failure," the authors write.