Interventions at Nurse Specialist Clinics for Cardiac Rehabilitation Patients at Auckland District Health Board: A 3-Month Snapshot

Abstracts

704 Incorporating Cardiopulmonary Resuscitation Training into a Cardiac Rehabilitation Program: A Feasibility Study S. Cartledge 1,2,∗ , J. Finn 1,3 , J. Bray 1,2,3 , R. Case 1 , L. Barker 4 , D. Missen 4 , J. Shaw 1,4,5 , D. Stub 1,2,4,5,6 1 Monash

University, Melbourne, Australia Hospital, Melbourne, Australia 3 Curtin University, Bentley, Australia 4 Cabrini Hospital, Melbourne, Australia 5 Baker Heart and Diabetes Institute, Melbourne, Australia 6 Western Health, Melbourne, Australia 2 Alfred

Aim: Targeting cardiopulmonary resuscitation (CPR) training to high-risk cardiac populations has long been advocated, but is an area in need of research evidence. We investigated the feasibility of providing CPR training in a cardiac rehabilitation program to cardiac patients and their family members. Methods: A prospective before and after study design was used. CPR training was delivered using video self-instruction (VSI) CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Results: Cardiac patient participation rates in CPR classes were high (n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use CPR skills significantly increased post-training (both p < 0.001). Skills assessed post-training demonstrated a mean compression rate of 112 beats per minute and a mean depth of 48 millimetres. Training reach was doubled as participants shared the VSI kit with a further 87 people. Training received positive feedback from participants and cardiac rehabilitation staff strongly agreed or agreed that CPR training was an appropriate addition to their program. Conclusion: We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using VSI CPR training kits enabled further training reach to the target population. Future large scale studies are now needed to assess whether this training is suitable in different types of cardiac rehabilitation programs. http://dx.doi.org/10.1016/j.hlc.2017.06.705 705 Interventions at Nurse Specialist Clinics for Cardiac Rehabilitation Patients at Auckland District Health Board: A 3-Month Snapshot J. Benatar ∗ , S. Reed, C. Gaspirini, Y. Johannsen, W. Marshall Auckland District Health Board, Auckland, New Zealand Background: Early nurse follow-up clinics 2- 3 weeks post hospital discharge have been instituted at ADHB since 2012.

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In the last 2 years these clinics have increased in attendance rates, patient complexity and now have medical supervision. Some patients will only have nurse follow-up post discharge. Aim: To assess rates of adherence and intervention in CR nurse clinics. Methods: The Cardiac Rehabilitation (CR) team at the Auckland District Health Board have prospectively recorded rates of adherence and interventions at nurse specialist clinics over a 6-month period. Results: 161 (89%) patients attended CR nurse clinics. Of these 45 (28%) patients required medication changes with 20 prescribed/up titration in ACE inhibitor/beta blocker, 2 antiplatelet agent, 11 statin and other 13 medication. A further 18 (12%) were referred for further investigation and, 15 (9%) to appropriate specialist clinics, for example diabetes/hyperventilation clinics. Conclusion: Nurse specialist clinics with medical supervision that are scheduled early post discharge provide a safety net for patients who are discharged following short hospital stays. They also lead to increased prescription of secondary prevention medication and ensure patients have appropriate investigations and referrals http://dx.doi.org/10.1016/j.hlc.2017.06.706 706 Physical Activity Level and Androgen Concentrations Are Independently and Additively Associated with Lower Cardiometabolic Risk in Men L. Chasland 1,∗ , M. Knuiman 1 , M. Divitini 1 , Y. Chan 1,2 , D. Handelsman 3 , L. Naylor 1,2 , B. Yeap 1,2 , D. Green 1 1 University of Western Australia, Perth, Australia 2 Fiona Stanley Hospital, Perth, Australia 3 ANZAC Research Institute, Sydney, Australia

Purpose: Male ageing is associated with increased incidence of cardiovascular disease (CVD) and lower circulating testosterone (T). However, whether physical activity (PA) interacts with sex hormones to modify CVD risk is unclear. We assessed whether PA and sex hormone concentrations were independently associated with measures of CVD risk in 1649 men. Methods: Leisure, home, work and total PA were ascertained via questionnaire. At baseline, serum T, dihydrotestosterone (DHT) and estradiol (E2) were assayed. Men were stratified into high PA + high hormone (H/H); low PA + high hormone (L/H); high PA + low hormone (H/L) and low PA + low hormone (L/L) groups. Results: Mean age was 49.8 years at outset with 415 CVD events and 127 CVD deaths occurring during 20-year followup. Men with higher PA and higher T or DHT had lower odds of metabolic syndrome (leisure H/H vs L/L odds ratio [OR] 0.17 p < 0.001 for T, 0.26 p < 0.001 for DHT). Men with higher PA and E2 had lower risk of metabolic syndrome (leisure PA H/H vs L/L OR 0.51, p = 0.001). Men with higher leisure PA and higher DHT had the lowest risk of CVD events (H/H hazard ratio [HR] 0.72 vs L/L, p = 0.016) and CVD death