- Email: [email protected]
Return to work issues following an acute cardiac event
Benefits: A 55% reduction in clinic time was observed (Physician; 7.0 min CLIN vs. 3.0 min REM) with associated cost reductions (p < 0.001). Patient time burden reduced 85% (median 1:08–0:10 min) and mean cost reduction for patient per-visit of $121. Performance: CLIN triggered more patient interventions than REM (34 vs 14, p < 0.001). As expected many (21 vs 5) were re-programmings optimising device longevity following new implants. No significant differences were observed in medication changes, patient safety or symptom interventions. 19 Unscheduled REM occurred, 7 automatically initiated by devices, 12 patient initiated. Of these, 1 resulted in a CLIN, while 18 cases were prevented from visiting Clinic (1× phone Med change, 5× referrals, 12× no action). Acceptance: Patient surveys showed no significant differences between satisfaction levels with REM and CLIN. Conclusion: CareLink provides physicians with accurate, reliable data enabling appropriate patient management and provides reductions in clinic time and costs. Patients are accepting of the technology and receive significant time and cost savings versus clinic based follow-up. doi:10.1016/j.hlc.2009.05.657 612 RETURN TO WORK ISSUES FOLLOWING AN ACUTE CARDIAC EVENT K. Page 1 , C. Sabine 2 , L. Worrall-Carter 1 1 St
Vincent’s/ACU National, Melbourne, Australia Health/Deakin University, Melbourne, Australia
2 Eastern
Background: Successful reintegration into the paid workforce is a key goal of cardiac rehabilitation. However, there is limited research in this area. This study aimed to explore the relationship of the Work Ability Index (WAI) with actual returning to work; and demographic and clinical characteristics that may impact upon ability to return to work. Method: The study consisted of 284 individuals who were admitted to a tertiary referral hospital in Melbourne with ACS over a 12-month period. Participants completed a questionnaire which included the Work Ability Index (WAI), ENRICHD Social Support Instrument (ESSI), Short-Form 36 Health Survey (SF-36) and Cardiac Depression Scale (CDS). Response rate was 11%. Results: 68% of respondents returned to work. Significant associations were found between the WAI and return to work data (p = 0.003). Depressive symptoms levels were present in 40% of participants. WAI scores were associated with CDS scores (p = 0.003) and SF-36 items (p ≤ 0.001). No association was present between WAI and social support. Conclusion: This study demonstrates that the WAI could be an effective first line screening tool for identifying those most likely to return to work and those who may need additional support. The results support existing evidence that quality of life and depression are factors that impact upon a person’s ability or confidence to return to work
Abstracts
S267
after an ACS event. In addition, those who have returned to work are more likely to have an improved quality of life than those who do not subsequently return to work. doi:10.1016/j.hlc.2009.05.658 613 SMOKING CESSATION THROUGH A SIMULATED TEACHABLE MOMENT: FEASIBILITY AND EARLY RESULTS OF A NOVEL BEHAVIOUR MODIFICATION TECHNIQUE USING PERSONAL IDENTIFICATION Robin May, Geoffrey Tofler, Roger Bartrop, Heinreich, John Baird, Simon DeBurgh
Paul
Royal North Shore Hospital, Sydney, Australia Background: Experiencing a myocardial infarction (MI) can be a “teachable moment” that results in smoking cessation where prior efforts have failed. Purpose: To determine feasibility of creating a simulated and personalised teachable moment to facilitate quitting. Methods: Smokers with no related illness, and a non-smoking partner, have photographs of themselves, partner and family, inserted into a video depicting a smoker (by imagery, themselves) experiencing an MI with potential personal and family consequences. A psychologist evaluates responses and uses motivational interviewing to reinforce quitting efficacy. Carbon monoxide (CO) and smoking status are evaluated at baseline, 1 week (with repeat video) 3 and 6 months. One week results are presented, with later follow-up ongoing. Results: Thirteen subjects (11 male, 2 female) aged 45 ± 12 years (mean, SD) have completed baseline and week 1. Four subjects also used quitting aids. Fagestrom score (nicotine tolerance) was 3.7 ± 2.9. Seven subjects had observable responses to the video including “looking uncomfortable”, “red eyes, difficulty speaking”. Selfreports included “made me aware of the important things” and “it felt very real”. At week 1 evaluation, Impact of Event Scale was 8.1 ± 7.5 without deleterious effect. Seven of 13 subjects reported stopping smoking, and the other 6 had reduced consumption. Daily cigarettes fell from 17.3 ± 9.3 at baseline to 2.7 ± 4.9, p < 0.001 at week 1, and CO levels from 15.7 ± 9.9 to 3.1 ± 3.2, p = 0.001. Conclusion: It is feasible to create a personalised simulated teachable moment. Early results provide encouragement for further investigation of this novel method for smoking cessation, and for other behaviour modification. doi:10.1016/j.hlc.2009.05.659
ABSTRACTS
Heart, Lung and Circulation 2009;18S:S1–S286
Vincent’s/ACU National, Melbourne, Australia Health/Deakin University, Melbourne, Australia
2 Eastern
Background: Successful reintegration into the paid workforce is a key goal of cardiac rehabilitation. However, there is limited research in this area. This study aimed to explore the relationship of the Work Ability Index (WAI) with actual returning to work; and demographic and clinical characteristics that may impact upon ability to return to work. Method: The study consisted of 284 individuals who were admitted to a tertiary referral hospital in Melbourne with ACS over a 12-month period. Participants completed a questionnaire which included the Work Ability Index (WAI), ENRICHD Social Support Instrument (ESSI), Short-Form 36 Health Survey (SF-36) and Cardiac Depression Scale (CDS). Response rate was 11%. Results: 68% of respondents returned to work. Significant associations were found between the WAI and return to work data (p = 0.003). Depressive symptoms levels were present in 40% of participants. WAI scores were associated with CDS scores (p = 0.003) and SF-36 items (p ≤ 0.001). No association was present between WAI and social support. Conclusion: This study demonstrates that the WAI could be an effective first line screening tool for identifying those most likely to return to work and those who may need additional support. The results support existing evidence that quality of life and depression are factors that impact upon a person’s ability or confidence to return to work
Abstracts
S267
after an ACS event. In addition, those who have returned to work are more likely to have an improved quality of life than those who do not subsequently return to work. doi:10.1016/j.hlc.2009.05.658 613 SMOKING CESSATION THROUGH A SIMULATED TEACHABLE MOMENT: FEASIBILITY AND EARLY RESULTS OF A NOVEL BEHAVIOUR MODIFICATION TECHNIQUE USING PERSONAL IDENTIFICATION Robin May, Geoffrey Tofler, Roger Bartrop, Heinreich, John Baird, Simon DeBurgh
Paul
Royal North Shore Hospital, Sydney, Australia Background: Experiencing a myocardial infarction (MI) can be a “teachable moment” that results in smoking cessation where prior efforts have failed. Purpose: To determine feasibility of creating a simulated and personalised teachable moment to facilitate quitting. Methods: Smokers with no related illness, and a non-smoking partner, have photographs of themselves, partner and family, inserted into a video depicting a smoker (by imagery, themselves) experiencing an MI with potential personal and family consequences. A psychologist evaluates responses and uses motivational interviewing to reinforce quitting efficacy. Carbon monoxide (CO) and smoking status are evaluated at baseline, 1 week (with repeat video) 3 and 6 months. One week results are presented, with later follow-up ongoing. Results: Thirteen subjects (11 male, 2 female) aged 45 ± 12 years (mean, SD) have completed baseline and week 1. Four subjects also used quitting aids. Fagestrom score (nicotine tolerance) was 3.7 ± 2.9. Seven subjects had observable responses to the video including “looking uncomfortable”, “red eyes, difficulty speaking”. Selfreports included “made me aware of the important things” and “it felt very real”. At week 1 evaluation, Impact of Event Scale was 8.1 ± 7.5 without deleterious effect. Seven of 13 subjects reported stopping smoking, and the other 6 had reduced consumption. Daily cigarettes fell from 17.3 ± 9.3 at baseline to 2.7 ± 4.9, p < 0.001 at week 1, and CO levels from 15.7 ± 9.9 to 3.1 ± 3.2, p = 0.001. Conclusion: It is feasible to create a personalised simulated teachable moment. Early results provide encouragement for further investigation of this novel method for smoking cessation, and for other behaviour modification. doi:10.1016/j.hlc.2009.05.659
ABSTRACTS
Heart, Lung and Circulation 2009;18S:S1–S286