Browsing by Author "Ignaszewski, Andrew"
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- ItemHeart failure disease management program, its contribution to established pharmacotherapy and long-term prognosis in real clinical practice - retrospective data analysis.(0000-00-00) Lazarova, Marie; Lazar, Dusan; Malek, Filip; Vaclavik, Jan; Taborsky, Milos; Ignaszewski, AndrewBACKGROUND AND AIMS The prognosis of patients with heart failure HF is still generally unfavorable HF with reduced ejection fraction HFrEF patients reach target medication doses in very low percentages in daily clinical practice HF disease management programs DMP including nurse and telemedicine support that facilitate achieving target medication doses may improve the unfavorable prognosis METHODS We retrospectively analyzed the data of 738 patients with HFrEF who were followed in a single HF center during the years 1975 2011 for 6 4 median years DMP nurse and telemedicine support is established at this center RESULTS The group achieved left ventricle LV recovery after the HF treatment The median LV ejection fraction improved from 25 0 at baseline to 50 0 at the time of the latest data collection The proportion of NYHA II III and IV classes decreased from 27 6 30 2 and 29 7 to 26 6 7 2 and 0 1 respectively while the proportion of NYHA class I increased from 12 5 to 66 1 Median NT proBNP decreased from 975 0 to 324 0 pg mL The survival of the patient group was favorable 79 7 survived 18 1 years after diagnosis of HF A high percentage of the patients received recommended target or higher than target doses of angiotensin converting enzyme inhibitors 82 0 and beta blockers 78 1 CONCLUSION The established pharmacotherapy resulted from an effective DMP and this contributed to the favorable prognosis
- ItemRandomized trial of a virtual cardiac rehabilitation program delivered at a distance via the Internet.(2014-11-22) Lear, Scott A; Singer, Joel; Banner-Lukaris, Davina; Horvat, Dan; Park, Julie E; Bates, Joanna; Ignaszewski, Andrew
- ItemUtilization of the internet to deliver cardiac rehabilitation at a distance: a pilot study.(2007-07-02) Zutz, Amber; Ignaszewski, Andrew; Bates, Joanna; Lear, Scott ALess than 25 of eligible patients attend cardiac rehabilitation programs CRP with geographical proximity being a predominant barrier Therefore we undertook a pilot study to assess the feasibility and safety of using the Internet as a medium for delivery of an interactive virtual CRP vCRP to patients at a distance Fifteen patients on the waiting list for a local hospital based CRP were randomized to either an Internet based vCRP or observational control The vCRP consisted of on line intake forms one on one chat sessions with a nurse dietitian and exercise specialist downloadable exercise heart rate monitoring education and data monitoring of blood pressure weight and glucose Participants were assessed for exercise capacity risk factors and lifestyle behaviors at baseline and at 12 weeks Those in the vCRP logged onto the Internet based CRP an average of 4 2 times per week There were no adverse events in the vCRP participants The vCRP group significantly improved their HDL C triglycerides total cholesterol HDL C ratio exercise capacity as assessed in metabolic equivalents weekly physical activity and exercise specific self efficacy p Under 0 05 There were no significant improvements in the control group Improvements in the vCRP group were similar to historical controls in a standard CRP Feedback from exit interviews of the vCRP participants was unanimously positive This Internet based CRP resulted in clinically significant improvements in risk factors and exercise capacity similar to that of a standard CRP The high user acceptance indicated that this program may have the potential to effectively manage patients who do not have access to traditional hospital based CRP
- ItemWhat Do Patients Talk About? A Qualitative Analysis of Online Chat Sessions with Healthcare Specialists During a "Virtual" Cardiac Rehabilitation Program.(0000-00-00) Mendell, Joanna; Bates, Joanna; Banner-Lukaris, Davina; Horvat, Dan; Kang, Bindy; Singer, Joel; Ignaszewski, Andrew; Lear, Scott AINTRODUCTION Cardiac rehabilitation programs CRPs are effective at reducing cardiovascular disease CVD risk yet attendance in these programs remains low due to geographic constraints In a previously conducted randomized trial we demonstrated that a virtual CRP vCRP delivered over the Internet reduced risk for CVD The current investigation has reviewed the online chat sessions between participants and healthcare providers HCP to describe the content of discussions during the vCRP intervention MATERIALS AND METHODS Participants were recruited from two geographically isolated areas in British Columbia Canada without in person CRP or a cardiologist serving the area The vCRP among other elements included scheduled one on one chat sessions with a dietician exercise specialist and nurse to mimic standard CRP consultations The chat sessions were reviewed for content and themes Multiple chat sessions between participants and a single care provider were also analyzed to describe how chat content progressed through multiple sessions RESULTS A total of 38 participants participated in the vCRP intervention From the 122 chat sessions between participants and HCP during the vCRP the main themes identified were Managing Health and Lifestyle Continuity of Care and Getting Care from a Distance Within each theme sub themes were also identified CONCLUSIONS The vCRP chat sessions fulfilled the role of face to face consultations with HCP that are standard in hospital based CRP and addressed patient concerns facilitating remote patient provider interaction and covering topics on exercise diet and positive behavior changes to limit risk factors for future heart problems