Effectiveness of Cardiac Rehabilitation on Health-related Quality of Life in Patients with Myocardial Infarction in Pakistan

Abstract

Objective: To find out the effectiveness of cardiac rehabilitation in patients with myocardial infarction in Pakistan.

Study design: Randomised controlled trial.

Place and duration of study: Cardiac Rehabilitation Unit, Lady Reading Hospital, Peshawar, Pakistan, from July to December 2016.

Methodology: Patients suffering first myocardial infarction (MI) were randomly allocated to usual care or cardiac rehabilitation in a 1:1 ratio. Cardiac rehabilitation comprised two phases: 1-2 weeks during hospital stay followed by 6-7 weeks outpatient structured exercise programme. Two generic health related quality of life (HRQoL) outcomes (General Health Questionnaire (GHQ) and Self-Rated Health (SRH)) and one post-MI specific tool (MacNew QLMI) were measured at baseline and at 8 weeks follow-up among both groups. Lower SRH and GHQ scores and higher MacNew QLMI scores indicate better health status. Data were analysed using STATA 14.

Results: Out of 206 participants, 195 (94.6%) were analysed at the end of trial. The mean age was 53 +8.3 years. In the cardiac rehabilitation group, the mean SRH score changed from 3.97 +0.9 at baseline to 2.36 +0.8 at follow-up (p<0.001). The mean GHQ of the cardiac rehabilitation group was 21.26 +5.5 at baseline and it decreased significantly to 7.43 +4.2 at follow-up (p<0.001). The MacNew QLMI of the cardiac rehabilitation group increased from 3.61 +1.07 to 5.62 +0.5 (p<0.001). The multivariate regression of all three HRQoL measures confirmed better HRQoL following cardiac rehabilitation compared with usual care (all p<0.001).

Conclusion: Cardiac rehabilitation following MI was effective in terms of improving HRQoL and can be implement in Pakistan as it produced significant improvements in HRQoL.