We assessed the effects of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on mortality and readmissions by exploring results from the LC-REHAB trial. In all, 825 patients with ischaemic heart disease or heart failure were randomized to the intervention arm (LC-CR) or the control arm (standard CR) at three hospitals in Denmark. LC-CR was situational and inductive, with experienced patients as co-educators supplemented with two individual interviews. Group-based training and education hours were the same in both arms. Outcomes were time to death or readmission, length of stay and absolute number of deaths or readmissions. No between-arm differences were found in time to death, first readmission, or length of stay. Within 30 days after completion of CR, the absolute number of all-cause readmissions was 117 in the LC arm and 146 in the control arm, adjusted odds ratio 78 (95% CI: 0.61-1.01), P = 0.06. This trend diminished over time. Adding LC strategies to standard CR showed a short term but no significant long-term effect on mortality or readmissions. However, the study was not powered to detect differences in mortality and morbidity. Thus, a risk of overseeing a true effect was present.

中文翻译：

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心脏康复中患者教育策略“学习和应对”对再入院和死亡率的影响：一项随机对照试验 (LC-REHAB)。


我们通过探索 LC-REHAB 试验的结果，评估了心脏康复 (CR) 中患者教育策略“学习和应对”(LC) 对死亡率和再入院的影响。总之，丹麦三家医院的 825 名缺血性心脏病或心力衰竭患者被随机分配到干预组 (LC-CR) 或对照组（标准 CR）。 LC-CR 是情景性和归纳性的，由经验丰富的患者作为共同教育者，并辅以两次单独访谈。两组的团体训练和教育时间相同。结果是死亡或再入院的时间、住院时间以及死亡或再入院的绝对人数。在死亡时间、首次再入院时间或住院时间方面没有发现组间差异。 CR 完成后 30 天内，LC 组中全因再入院的绝对人数为 117 例，对照组为 146 例，调整后优势比为 78（95% CI：0.61-1.01），P = 0.06。随着时间的推移，这种趋势逐渐减弱。在标准 CR 的基础上添加 LC 策略对死亡率或再入院有短期影响，但没有显着的长期影响。然而，该研究无法检测死亡率和发病率的差异。因此，存在监督真实效果的风险。