CARDIAC DISEASE: DISASTER OR A DILEMMA? TRANSFORMING CARDIAC OUTCOMES IN THE UAE UTILIZING A MULTIDISCIPLINARY APPROACH

Background: The average age for cardiac arrest and cardiovascular disease (CVD) worldwide is 65 years, while people in the UAE are suffering from CVD at the age of 45. The UAE has all the risk factors for CVD. Obesity, diabetes, hypertension is on the rise. One in 3 Emiratis have hypertension, that leads to strokes, CVD and kidney disease. 
A Heart and Vascular specialty hospital opened in 2014 and started a Physical Therapy lead-cardiac rehabilitation program. This service is the only multi-disciplinary cardiac rehab program of its kind and includes physicians, dieticians, pharmacists, nurses, patient educators all working on the most important goal of rehabilitation which is to improve the Quality Of life, rehabilitate the myocardium and lower the mortality rates of our patients. The program empowers our patients to be more physically active, provides heart health education to promote self-management and lower risk factors.

Purpose: Reviewing cardiac rehabilitation outcomes of our program, 6MWT as primary outcome and Depression and Quality of Life as secondary.

Methods: The 6 Minute Walk Test (6MWT) was used to assess function on both first visit to establish a baseline and tailor a suitable program and last visit to re-assess function. Quality of life was measured by (EQ5d) and depression was measured by Patient Health Questionairre-9. Patients with a variety of cardiac conditions were provided with individualized intervention programs that included an exercise program in addition to consults and follow-ups with dieticians, pharmacists and patient educators to monitor lifestyle and implement healthy changes. Data from 121 patient records were randomly selected.

Results: 6MWT average total distance on first visit and last visit were: 338.7 and 382.1 meters, average improvement was 43.4 meters. The total number of patients who improved 96 patients, 11 patients with no change and 14 patients deteriorated. Average METs on first visit and last visit were: 2.65 and 2.81. Average (EQ-5D) on first visit and last visit were: 9.5 and 8.2. Average PHQ-9 on first visit and last visit were: 8.4 and 4.6.

Conclusion(s): The majority of the patient had a positive outcome related to our primary outcome measure, improved 6MWT distance should represent an improvement in function, physical capacity and quality of life. Quality of life as measured by (EQ-5D) did not improve, which is an unexpected finding as the majority of patient showed important physical function improvements. This has led to the program leaders to consider whether a different tool may be more appropriate or whether the patients need better education on how to complete the assessment. Depression scores improved during the program and the threshold of 13 was used to refer at risk patients to the psychiatrist.

Implications: In a country where the burden of cardiac disease is high these results show the important progress that participants in Physical Therapy-lead cardiac rehab program can achieve.

Funding, acknowledgements: No financial support was obtained for this study

Keywords: Cardiovascular Disease (CVD), Cardiac Rehabilitation, Physical Therapy

Topic: Cardiorespiratory

Did this work require ethics approval? No

Institution: Cleveland Clinic Abu Dhabi

Committee: Research Ethics Committee

Reason: The purpose of this abstract is to summarize data gathered from a patient registry.