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| Guideline
57 - Supporting Material |
| Cardiac
rehabiliation |
Search
narrative
The search narrative was designed
using the key question drawn up by the group and the Information Officer. Please
note the following:
- The search strategies used in
Medline, Healthstar, and Cinahl were substantially the same.
- At the systematic review stage,
the subgroups were Exercise, Psychology & Education, and Multifactorial,
each subgroup had the remit of the particular kind of intervention for all
kinds of patients needing cardiac rehabilitation. These subgroups were changed
to Exercise, Psychology & Education, and High Risk, where the first two
subgroups remit covered male myocardial infarction patients only, and
the last covered all other patient groups. This change was made to reflect
the research literature.
- The economic part of the economic
search strategy was derived from that available on the Centre for Reviews
and Dissemination website.
- Supplementary searches were conducted
by a librarian in PsychLit, a database that SIGN cannot access.
- The year range for the randomised
controlled trial search was from 1995 onwards instead of 1991 onwards as the
group had a good quality systematic review which covered the literature up
to 1995.
Summary
Systematic review search
Year range: 1991-2000
Databases: Medline, Embase, Cinahl, Healthstar, the Internet, and the Cochrane
Library Date completed: May 2000 for all subgroups
Randomised controlled trials
Year range: 1995-2000 for the High Risk and Psychology & Education subgroups,
1995-2001 for the Exercise subgroup
Databases: Medline, Embase, Cinahl, Healthstar, and the Cochrane Library
Date completed: December 2000 for the High Risk and Psychology & Education
subgroups, February 2001 for the Exercise subgroup
Extra searches
A search on economics and cardiac rehabiliation was conducted for the groups
health economist
Filters: none
Year range: 1998-2000
Databases: Medline, Embase, Cinahl, Healthstar, NEED, and the Cochrane Library
Date completed: October 2000
The Psychology & Education requested a extra search in PsychINFO
Filters: systematic reviews and rcts
Databases: PsychINFO
Date completed: October 2000
Notes: PsychINFO was not available at the time of the original searches
Internet
The Internet search included the following sites:
AARC Clinical Practice Guidelines
http://www.rcjournal.com/online_resources/cpgs/cpg_index.asp
National Guidelines Clearinghouse
http://www.guidelines.gov/index.asp
ACC/AHA Practice Guidelines
http://www.acc.org/clinical/statements.htm
NHMRC
http://www.health.gov.au/nhmrc/publications/index.htm
Canadian Task Force on Preventive
Health Care
http://www.ctfphc.org/
Health Services/Technology Assessment
Text
http://text.nlm.nih.gov/
Agency for Health Care and Policy
Research
http://www.ahcpr.gov/
These searches were carried out using
the Ovid implementation of Medline. A * before a search term indicates that
that term was focused - i.e. limited to records where the term was a major MeSH
term. "exp" before a term indicates that the term was exploded. A
/ after a term indicates that all subheadings were selected. A $ at the end
of a term indicates that this term has been truncated.
Systematic reviews for all subgroups
All subgroups Medline systematic
review strategy
- (cardiac adj rehab$).mp
|
Identifies
cardiac rehabilitation. |
- exp myocardial infarction/
- myocardial infarction.tw
- mi.tw
- myocardial ischemia/
- exp angina pectoris/
- exp heart failure, congestive/
- exp heart defects, congenital/
- exp heart valve diseases/
- rheumatic heart diseases/
- exp heart transplantation/
- angioplasty, transluminal,
percutaneous coronary/
- ptca.tw
- coronary disease/
- cardiovascular diseases/
- heart diseases/
- coronary artery bypass/
- cabg.tw
- heart disease$.tw
- or/2-19
|
Identify conditions
and interventions related to cardiac rehabilitation. |
- rehabilitation/
- rehab$.tw
- rehabilitation centers/
- rehabilitation nursing/
- activities of daily living/
- exp quality of life/
- qol.tw
- health status indicators/
- severity of illness index/
- stress, psychological/
- employment/
- unemployment/
- work/px
- depression/
- anxiety/
- adaptation, psychological/
- exp morbidity/
- comorbidity/
- exp mortality/
- cardiac output/
- stroke volume/
- cost of illness/
- cost-benefit analysis/
- "costs and cost analysis"/
- cost control/
- cost savings/
- exp health care costs/
- exp health expenditures/
- economic value of life/
- exp economics, medical/
- economics, nursing/
- health care sector/
- smoking/
- smoking cessation/
- alcohol drinking/
- alcoholism/
- exp lipids/
- exp hypertension/
- exp hyperlipidemia/
- exp hyperlipidemia, familial
combined/
- exp diabetes mellitus/
- exp obesity/
- life style/
- genetic predisposition to
disease/
- disease susceptibility/
- exp diet therapy/
|
Identify rehabilitation
and outcomes/conditions related to cardiac rehabilitation. |
- or/21-66
|
|
- exp cardiovascular diseases/rh
|
Identifies
cardiac rehabilitation. |
- exercise tolerance/
- exercise.tw
- exercise test/
- exercise therapy/
- physical fitness/
- oxygen consumption/
- carbon dioxide/ph
- exercise/
|
Identify exercise. |
- or/69-76
|
|
- ((20 and 67) or 1 or 68)
and 77
|
Identifies
cardiac rehabilitation with exercise. |
- behavior therapy/
- (behavio?r$ adj therapy).tw
- cognitive therapy/
- cognitive therapy.tw
- cbt.tw
- psychotherapy/
- counseling/
- (counselling or counseling).tw
- psychoanalysis/
- exp emotions/
- exp attitude to health/
- health behavior/
- patient education/
- patient compliance/
- health promotion/
- sick role/
- patient participation/
- treatment refusal/
- occupational therapy/
- mental health/
- self efficacy/
- internal-external control/
- exp relaxation techniques/
- psychology, social/
- social support/
- exp personality/
- exp socioeconomic factors/
|
Identify psychosocial
factors and interventions. |
- or/79-105
|
|
- ((20 and 67) or 1 or 68)
and 106
|
Identifies
cardiac rehabilitation with psychosocial factors and interventions. |
- (multi$ adj intervention).mp
- disease management/
- patient care team/
- patient care management/
- critical pathways/
- delivery of health care/
- multifactor$.tw
|
Identify
multifactorial interventions. |
- or/108-114
|
|
- (((20 and 67) or 1 or 68)
and (115 or (77 and 106))
|
Identifies
cardiac rehabilitation with multifactorial interventions/interventions including
both exercise and psycholsocial interventions. |
Exercise
Exercise subgroup Medline randomised
controlled trials strategy
- Myocardial infarction/
- myocardial stunning/
- Shock, cardiogenic/
- (myocardial adj infarction
$).mp.
- coronary disease/
- mi.tw
|
Identify myocardial
infarction. |
- or/1-6
|
|
- rehabilitation/
- rehabilitation centres/
- rehabilitation nursing/
- Activities of daily living/
- rehab $.tw.
|
Identify
rehabilitation. |
- or/8-12
|
|
- (cardiac adj rehab $).mp.
- exp cardiovascular diseases/rh
- Myocardial infarction/rh
|
Identify cardiac
rehabilitation. |
- (7 and 13) or 14 or 15 or
16
|
Draws
together all the cardiac rehabilitation material. |
- exercise/
- exercise.tw
- exercise tolerance/
- exercise test/
- kinesiotherapy/
- fitness/
- aerobic capacity/
- oxygen consumption/
|
Identify
exercise. |
- or/18-25
|
|
- 17 and 26
|
Identifies
cardiac rehabilitation with exercise. |
Psychology & Education
Psychology & Education Medline
randomised controlled trial strategy
- Myocardial infarction/
- myocardial stunning/
- Shock, cardiogenic/
- (myocardial adj infarction
$).mp.
- coronary disease/
- mi.tw
|
Identify myocardial
infarction. |
- or/1-6
|
|
- rehabilitation/
- rehabilitation centres/
- rehabilitation nursing/
- Activities of daily living/
- rehab $.tw.
|
Identify
rehabilitation. |
- or/8-12
|
|
- (cardiac adj rehab $).mp.
- exp cardiovascular diseases/rh
- Myocardial infarction/rh
|
Identify
cardiac rehabilitation. |
- (7 and 13) or 14 or 15 or
16
|
Draws
together all the cardiac rehabilitation material. |
- smoking/
- smoking cessation/
- alcohol drinking/
- alcoholism/
- lifestyle/
- exp diet therapy/
- quality of life/
- qol.tw
- quality-adjusted life years/
- behavior/
- health behavior/
- self care/
- self care.tw
- self efficacy/
- health education/
- health promotion/
- sick role/
|
Identify
outcomes related to lifestyle. |
- or/18-34
|
|
- patient education/
- patient education.tw
- patient compliance/
- patient satisfaction/
- patient acceptance of health
care/
- attitude to health/
- patient participation/
- treatment for refusal/
- health promotion/
- health education/
- (patient$ adj adherence).mp.
- knowledge, attitudes, practice/
|
Identify
patient education. |
- or/36-47
|
|
- (psychosocial adj intervention$).mp.
- behavior therapy/
- (behavio?r$ adj therapy).tw
- cognitive therapy/
- cognitive therapy.tw
- cbt.tw
- psychotherapy/
- counseling/
- (counselling or counseling).tw
- psychoanalysis/
- anxiety/
- depression/
- depressive disorder/
- anger/
- mental health/
- internal external
control/
- exp Relaxation techniques/
- stress, psychological/
- psychology, social/
- social support/
- type a personality/
- personality/
|
Identify
psychosocial factors and interventions. |
- or/49-70
|
|
- 17 and 35 and 48
|
Identifies cardiac rehabilitation with patient education and lifestyle. |
- 17 and 71
|
Identifies cardiac rehabilitation with psychosocial material. |
- 72 or 73
|
Draws all the material together. |
High Risk subgroup
High Risk subgroup Medline randomised
controlled trials strategy
- heart transplantation/
- heart-lung transplantation/
- (heart adj transplant$).mp
- (cardiac adj transplant$).mp
- (cardiac adj transplant$).mp
- (heart adj allograft).mp
- graft rejection/
- host vs graft reaction/
- graft survival/
- heart valves/
- aortic valve/
- chordae tendineae/
- mitral valve/
- papillary muscles/
- pulmonary valve/
- tricuspid valve/
- tricuspid valve insufficiency/
- aortic valve insufficiency/
- aortic valve stenosis/
- williams syndrome/
- heart murmurs/
- heart valve prolapse/
- aortic valve prolapse/
- mitral valve insufficiency/
- triscupid valve prolapse/
- mitral valve insufficency/
- mitral valve stenosis/
- pulmonary atresia/
- pulmonary valve insufficiency/
- triscupid atresia/
- triscupid valve stenosis/
- heart valve prosthesis implantation/
- (heart adj valve$).mp
- (cardiac adj valve$).mp
- (valve adj (surgery or surgical)).mp
- defibrillators, implantable/
- electric countershock/
- arterial fibrillation/
- defibrillator$.tw.
- pacemaker,artificial/
- pacemaker$.tw.
- electrodes, implanted/
- heart atrium/
- heart defects. congenital/
- aortic coarctation/
- arrhythmogenic right ventricular
dysplasia/
- cor triatriatum/
- coronary vessel anomalies/
- crisscross heart/
- dextrocardia/
- ductus arteriosus,patent/
- ebsteins anomaly/
- eisenmenger complex/
- heart septal defects/
- aortopulmonary septal defect/
- endocardial cushion defects/
- heart sepal defects, atrial/
- lutembachers syndrome/
- trilogy of fallot/
- heart septal defects, ventricular/
- hypoplastic left heart syndrome/
- levocardia/
- tetralogy of fallot/
- transposition of great vessels/
- double outlet right ventricle/
- truncus arteriosus, persistent/
- congenital heart disease$.tw.
- congenital heart defect
$.tw.
- congenital heart abnormalit$.tw.
- cardiovascular abnormalities/
- arterio-arterial fistula/
- arteriovenous malformations/
- arteriovenous fistula/
- myocardial revascularization/
- angioplasty, transluminal,
percutaneous coronary/
- atherectomy, coronary/
- coronary artery bypass/
- (bypass adj graft $).mp
- ptca.tw.
- cabg.tw.
- (coronary adj angioplasty).mp
- (percutaneous adj coronary).mp
- ((heart or cardiac or cardio$
or myocard$) and revasculari?ation).tw.
- exp angioplasty/
- stents/
- stent$.tw.
- angina, unstable/
- angina pectoris/
- angina pectoris, variant/
- syndrome x/
- angina.tw.
- heart failure, congestive/
- cardiomyopathy, congestive/
- dyspnea, paroxysmal/
- edema, cardiac/
- (heart adj failure).mp
- (cardiac adj failure).mp
|
Identify non-myocardial
infarction conditions and interventions related to cardiac rehabilitation. |
- or/1-97
|
|
- exp myocardial infarction/
- cardiovascular diseases/
- heart diseases/
- pregnancy complications,
cardiovascular/
- coronary disease/
- coronary aneurysm/
- coronary arteriosclerosis/
- coronary thrombosis/
- coronary vasospasm/
- (myocardial adj infarction).mp
- (heart adj attack).mp
- (cardiac adj attack).mp.
- (cardiac adj arrest).mp
|
Identify myocardial infarction
and other cardiac conditions. |
- or/99-111
|
|
- woman.tw.
- women.tw.
- female/
|
Identify women. |
- or/113-115
|
|
- limit 112 to ( "aged
<65 and over > "or" aged , 80 and over")
|
Identifies myocardial infarction
and other cardiac conditions in the elderly. |
- rehabilitation/
- rehabilitation centers/
- rehabilitation nursing/
- activities of daily living/
- rehab$.tw.
|
Identify rehabilitation.
|
- or 118-122
- (cardiac adj rehab$).mp
- exp cardiovascular diseases/rh
|
|
- 98 and (123 or 124 or 125)
|
Identifies non-myocardial infarction
conditions and rehabilitation. |
- 112 and 116 and (123 or
124 or 125)
|
Identifies myocardial infarction
in women with rehabilitation. |
- 117 and (123 or 124 or 125)
|
Identifies myocardial infarction
in the elderly with rehabilitaiton. |
Economics
Economics Medline strategy
- (cardiac adj rehab$).mp
- exp cardiovascular diseases/rh
|
Identify cardiac rehabilitation.
|
- exp myocardial infarction/
- mi.tw
- myocardial ischemia/
- exp angina pectoris/
- exp heart failure, congestive/
- exp heart defects, congenital/
- exp heart valve diseases/
- rheumatic heart disease/
- exp heart transplantation/
- angioplasty, transluminal,
percutaneous coronary/
- ptca.tw
- coronary disease/
- cardiovascular diseases/
- heart diseases/
- coronary artery bypass/
- cabg.tw
- (heart adj disease$).mp
- (myocard$ adj infarct$).mp
|
Identify conditions and
interventions related to cardiac rehabilitation. |
- or/3-20
|
|
- rehabilitation/
- rehabilitation centers/
- rehabilitation nursing/
- activities of daily living/
- exp quality of life/
- health status indicators/
- severity of illness index/
- rehab$.tw
- self care/
|
Identify rehabilitation.
|
- or/22-30
|
|
- 1 or 2 or (21 and 31)
|
Draws together all cardiac
rehabilitation material. |
- economics/
- "costs and cost analysis"/
- cost allocation/
- cost-benefit analysis/
- cost control/
- cost savings/
- cost of illness/
- cost sharing/
- "deductibles and coinsurance"/
- medical savings accounts/
- health care costs/
- direct service costs/
- drug costs/
- employer health costs/
- hospital costs/
- health expenditures/
- capital expenditures/
- economic value of life/
- exp economics, dental/
- exp economics, hospital/
- exp economics, medical/
- economics, nursing/
- economics, pharmaceutical/
- exp "fees and charges"/
- exp budgets/
- (low adj cost).mp
- (high adj cost).mp
- (health?care adj cost$).mp
- (fiscal or funding or financial).mp
- (cost adj estimate$).mp
- (cost adj variable$).mp
- (unit adj cost$).mp
- (economic$ or parmacoeconomic$
or price$ or pricing).tw
- or/33-65
- letter.pt
- editorial.pt
- historical article.pt
- or/67-69
- animal/
- human/
- 71 not (71 and 72)
- 66 not 70
- 74 not 73
|
Identify economic studies
(strategy adapted from that of Centre for Reviews and Dissemination).
|
- 32 and 75
|
Identifies cardiac rehabilitation
economic studies. |
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