Guideline 57: Cardiac rehabilitation - Supporting material

Search narrative

The search narrative was designed using the key question drawn up by the group and the Information Officer. Please note the following:

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 group’s 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

  1. (cardiac adj rehab$).mp
Identifies cardiac rehabilitation.
  1. exp myocardial infarction/
  2. myocardial infarction.tw
  3. mi.tw
  4. myocardial ischemia/
  5. exp angina pectoris/
  6. exp heart failure, congestive/
  7. exp heart defects, congenital/
  8. exp heart valve diseases/
  9. rheumatic heart diseases/
  10. exp heart transplantation/
  11. angioplasty, transluminal, percutaneous coronary/
  12. ptca.tw
  13. coronary disease/
  14. cardiovascular diseases/
  15. heart diseases/
  16. coronary artery bypass/
  17. cabg.tw
  18. heart disease$.tw
  19. or/2-19
Identify conditions and interventions related to cardiac rehabilitation.
  1. rehabilitation/
  2. rehab$.tw
  3. rehabilitation centers/
  4. rehabilitation nursing/
  5. activities of daily living/
  6. exp quality of life/
  7. qol.tw
  8. health status indicators/
  9. severity of illness index/
  10. stress, psychological/
  11. employment/
  12. unemployment/
  13. work/px
  14. depression/
  15. anxiety/
  16. adaptation, psychological/
  17. exp morbidity/
  18. comorbidity/
  19. exp mortality/
  20. cardiac output/
  21. stroke volume/
  22. cost of illness/
  23. cost-benefit analysis/
  24. "costs and cost analysis"/
  25. cost control/
  26. cost savings/
  27. exp health care costs/
  28. exp health expenditures/
  29. economic value of life/
  30. exp economics, medical/
  31. economics, nursing/
  32. health care sector/
  33. smoking/
  34. smoking cessation/
  35. alcohol drinking/
  36. alcoholism/
  37. exp lipids/
  38. exp hypertension/
  39. exp hyperlipidemia/
  40. exp hyperlipidemia, familial combined/
  41. exp diabetes mellitus/
  42. exp obesity/
  43. life style/
  44. genetic predisposition to disease/
  45. disease susceptibility/
  46. exp diet therapy/
 Identify rehabilitation and outcomes/conditions related to cardiac rehabilitation.
  1. or/21-66
  
  1. exp cardiovascular diseases/rh
 Identifies cardiac rehabilitation.
  1. exercise tolerance/
  2. exercise.tw
  3. exercise test/
  4. exercise therapy/
  5. physical fitness/
  6. oxygen consumption/
  7. carbon dioxide/ph
  8. exercise/
 Identify exercise.
  1. or/69-76
  
  1. ((20 and 67) or 1 or 68) and 77
 Identifies cardiac rehabilitation with exercise.
  1. behavior therapy/
  2. (behavio?r$ adj therapy).tw
  3. cognitive therapy/
  4. cognitive therapy.tw
  5. cbt.tw
  6. psychotherapy/
  7. counseling/
  8. (counselling or counseling).tw
  9. psychoanalysis/
  10. exp emotions/
  11. exp attitude to health/
  12. health behavior/
  13. patient education/
  14. patient compliance/
  15. health promotion/
  16. sick role/
  17. patient participation/
  18. treatment refusal/
  19. occupational therapy/
  20. mental health/
  21. self efficacy/
  22. internal-external control/
  23. exp relaxation techniques/
  24. psychology, social/
  25. social support/
  26. exp personality/
  27. exp socioeconomic factors/
 Identify psychosocial factors and interventions.
  1. or/79-105
  
  1. ((20 and 67) or 1 or 68) and 106
 Identifies cardiac rehabilitation with psychosocial factors and interventions.
  1. (multi$ adj intervention).mp
  2. disease management/
  3. patient care team/
  4. patient care management/
  5. critical pathways/
  6. delivery of health care/
  7. multifactor$.tw
 Identify multifactorial interventions.
  1. or/108-114
  
  1. (((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

  1. Myocardial infarction/
  2. myocardial stunning/
  3. Shock, cardiogenic/
  4. (myocardial adj infarction $).mp.
  5. coronary disease/
  6. mi.tw
Identify myocardial infarction.
  1. or/1-6
  
  1. rehabilitation/
  2. rehabilitation centres/
  3. rehabilitation nursing/
  4. Activities of daily living/
  5. rehab $.tw.
Identify rehabilitation.
  1. or/8-12
  
  1. (cardiac adj rehab $).mp.
  2. exp cardiovascular diseases/rh
  3. Myocardial infarction/rh
Identify cardiac rehabilitation.
  1. (7 and 13) or 14 or 15 or 16
Draws together all the cardiac rehabilitation material.
  1. exercise/
  2. exercise.tw
  3. exercise tolerance/
  4. exercise test/
  5. kinesiotherapy/
  6. fitness/
  7. aerobic capacity/
  8. oxygen consumption/
Identify exercise.
  1. or/18-25
  
  1. 17 and 26
Identifies cardiac rehabilitation with exercise.

Psychology & Education

Psychology & Education Medline randomised controlled trial strategy

  1. Myocardial infarction/
  2. myocardial stunning/
  3. Shock, cardiogenic/
  4. (myocardial adj infarction $).mp.
  5. coronary disease/
  6. mi.tw
Identify myocardial infarction.
  1. or/1-6
  
  1. rehabilitation/
  2. rehabilitation centres/
  3. rehabilitation nursing/
  4. Activities of daily living/
  5. rehab $.tw.
 Identify rehabilitation.
  1. or/8-12
  
  1. (cardiac adj rehab $).mp.
  2. exp cardiovascular diseases/rh
  3. Myocardial infarction/rh
Identify cardiac rehabilitation.
  1. (7 and 13) or 14 or 15 or 16
Draws together all the cardiac rehabilitation material.
  1. smoking/
  2. smoking cessation/
  3. alcohol drinking/
  4. alcoholism/
  5. lifestyle/
  6. exp diet therapy/
  7. quality of life/
  8. qol.tw
  9. quality-adjusted life years/
  10. behavior/
  11. health behavior/
  12. self care/
  13. self care.tw
  14. self efficacy/
  15. health education/
  16. health promotion/
  17. sick role/
Identify outcomes related to lifestyle.
  1. or/18-34
  
  1. patient education/
  2. patient education.tw
  3. patient compliance/
  4. patient satisfaction/
  5. patient acceptance of health care/
  6. attitude to health/
  7. patient participation/
  8. treatment for refusal/
  9. health promotion/
  10. health education/
  11. (patient$ adj adherence).mp.
  12. knowledge, attitudes, practice/
Identify patient education.
  1. or/36-47
  
  1. (psychosocial adj intervention$).mp.
  2. behavior therapy/
  3. (behavio?r$ adj therapy).tw
  4. cognitive therapy/
  5. cognitive therapy.tw
  6. cbt.tw
  7. psychotherapy/
  8. counseling/
  9. (counselling or counseling).tw
  10. psychoanalysis/
  11. anxiety/
  12. depression/
  13. depressive disorder/
  14. anger/
  15. mental health/
  16. internal –external control/
  17. exp Relaxation techniques/
  18. stress, psychological/
  19. psychology, social/
  20. social support/
  21. type a personality/
  22. personality/
Identify psychosocial factors and interventions.
  1. or/49-70
  
  1. 17 and 35 and 48
Identifies cardiac rehabilitation with patient education and lifestyle.
  1. 17 and 71
Identifies cardiac rehabilitation with psychosocial material.
  1. 72 or 73
Draws all the material together.

High Risk subgroup

High Risk subgroup Medline randomised controlled trials strategy

  1. heart transplantation/
  2. heart-lung transplantation/
  3. (heart adj transplant$).mp
  4. (cardiac adj transplant$).mp
  5. (cardiac adj transplant$).mp
  6. (heart adj allograft).mp
  7. graft rejection/
  8. host vs graft reaction/
  9. graft survival/
  10. heart valves/
  11. aortic valve/
  12. chordae tendineae/
  13. mitral valve/
  14. papillary muscles/
  15. pulmonary valve/
  16. tricuspid valve/
  17. tricuspid valve insufficiency/
  18. aortic valve insufficiency/
  19. aortic valve stenosis/
  20. williams syndrome/
  21. heart murmurs/
  22. heart valve prolapse/
  23. aortic valve prolapse/
  24. mitral valve insufficiency/
  25. triscupid valve prolapse/
  26. mitral valve insufficency/
  27. mitral valve stenosis/
  28. pulmonary atresia/
  29. pulmonary valve insufficiency/
  30. triscupid atresia/
  31. triscupid valve stenosis/
  32. heart valve prosthesis implantation/
  33. (heart adj valve$).mp
  34. (cardiac adj valve$).mp
  35. (valve adj (surgery or surgical)).mp
  36. defibrillators, implantable/
  37. electric countershock/
  38. arterial fibrillation/
  39. defibrillator$.tw.
  40. pacemaker,artificial/
  41. pacemaker$.tw.
  42. electrodes, implanted/
  43. heart atrium/
  44. heart defects. congenital/
  45. aortic coarctation/
  46. arrhythmogenic right ventricular dysplasia/
  47. cor triatriatum/
  48. coronary vessel anomalies/
  49. crisscross heart/
  50. dextrocardia/
  51. ductus arteriosus,patent/
  52. ebstein’s anomaly/
  53. eisenmenger complex/
  54. heart septal defects/
  55. aortopulmonary septal defect/
  56. endocardial cushion defects/
  57. heart sepal defects, atrial/
  58. lutembacher’s syndrome/
  59. trilogy of fallot/
  60. heart septal defects, ventricular/
  61. hypoplastic left heart syndrome/
  62. levocardia/
  63. tetralogy of fallot/
  64. transposition of great vessels/
  65. double outlet right ventricle/
  66. truncus arteriosus, persistent/
  67. congenital heart disease$.tw.
  68. congenital heart defect $.tw.
  69. congenital heart abnormalit$.tw.
  70. cardiovascular abnormalities/
  71. arterio-arterial fistula/
  72. arteriovenous malformations/
  73. arteriovenous fistula/
  74. myocardial revascularization/
  75. angioplasty, transluminal, percutaneous coronary/
  76. atherectomy, coronary/
  77. coronary artery bypass/
  78. (bypass adj graft $).mp
  79. ptca.tw.
  80. cabg.tw.
  81. (coronary adj angioplasty).mp
  82. (percutaneous adj coronary).mp
  83. ((heart or cardiac or cardio$ or myocard$) and revasculari?ation).tw.
  84. exp angioplasty/
  85. stents/
  86. stent$.tw.
  87. angina, unstable/
  88. angina pectoris/
  89. angina pectoris, variant/
  90. syndrome x/
  91. angina.tw.
  92. heart failure, congestive/
  93. cardiomyopathy, congestive/
  94. dyspnea, paroxysmal/
  95. edema, cardiac/
  96. (heart adj failure).mp
  97. (cardiac adj failure).mp
 Identify non-myocardial infarction conditions and interventions related to cardiac rehabilitation.
  1. or/1-97
 
  1. exp myocardial infarction/
  2. cardiovascular diseases/
  3. heart diseases/
  4. pregnancy complications, cardiovascular/
  5. coronary disease/
  6. coronary aneurysm/
  7. coronary arteriosclerosis/
  8. coronary thrombosis/
  9. coronary vasospasm/
  10. (myocardial adj infarction).mp
  11. (heart adj attack).mp
  12. (cardiac adj attack).mp.
  13. (cardiac adj arrest).mp

Identify myocardial infarction and other cardiac conditions.

  1. or/99-111
  
  1. woman.tw.
  2. women.tw.
  3. female/

Identify women.

  1. or/113-115
 		 
  1. limit 112 to ( "aged <65 and over > "or" aged , 80 and over")

Identifies myocardial infarction and other cardiac conditions in the elderly.

  1. rehabilitation/
  2. rehabilitation centers/
  3. rehabilitation nursing/
  4. activities of daily living/
  5. rehab$.tw.

Identify rehabilitation.

  1. or 118-122
  2. (cardiac adj rehab$).mp
  3. exp cardiovascular diseases/rh
  
  1. 98 and (123 or 124 or 125)

Identifies non-myocardial infarction conditions and rehabilitation.

  1. 112 and 116 and (123 or 124 or 125)

Identifies myocardial infarction in women with rehabilitation.

  1. 117 and (123 or 124 or 125)

Identifies myocardial infarction in the elderly with rehabilitaiton.

Economics

Economics Medline strategy

  1. (cardiac adj rehab$).mp
  2. exp cardiovascular diseases/rh

Identify cardiac rehabilitation.

  1. exp myocardial infarction/
  2. mi.tw
  3. myocardial ischemia/
  4. exp angina pectoris/
  5. exp heart failure, congestive/
  6. exp heart defects, congenital/
  7. exp heart valve diseases/
  8. rheumatic heart disease/
  9. exp heart transplantation/
  10. angioplasty, transluminal, percutaneous coronary/
  11. ptca.tw
  12. coronary disease/
  13. cardiovascular diseases/
  14. heart diseases/
  15. coronary artery bypass/
  16. cabg.tw
  17. (heart adj disease$).mp
  18. (myocard$ adj infarct$).mp

Identify conditions and interventions related to cardiac rehabilitation.

  1. or/3-20
  
  1. rehabilitation/
  2. rehabilitation centers/
  3. rehabilitation nursing/
  4. activities of daily living/
  5. exp quality of life/
  6. health status indicators/
  7. severity of illness index/
  8. rehab$.tw
  9. self care/

Identify rehabilitation.

  1. or/22-30
  
  1. 1 or 2 or (21 and 31)

Draws together all cardiac rehabilitation material.

  1. economics/
  2. "costs and cost analysis"/
  3. cost allocation/
  4. cost-benefit analysis/
  5. cost control/
  6. cost savings/
  7. cost of illness/
  8. cost sharing/
  9. "deductibles and coinsurance"/
  10. medical savings accounts/
  11. health care costs/
  12. direct service costs/
  13. drug costs/
  14. employer health costs/
  15. hospital costs/
  16. health expenditures/
  17. capital expenditures/
  18. economic value of life/
  19. exp economics, dental/
  20. exp economics, hospital/
  21. exp economics, medical/
  22. economics, nursing/
  23. economics, pharmaceutical/
  24. exp "fees and charges"/
  25. exp budgets/
  26. (low adj cost).mp
  27. (high adj cost).mp
  28. (health?care adj cost$).mp
  29. (fiscal or funding or financial).mp
  30. (cost adj estimate$).mp
  31. (cost adj variable$).mp
  32. (unit adj cost$).mp
  33. (economic$ or parmacoeconomic$ or price$ or pricing).tw
  34. or/33-65
  35. letter.pt
  36. editorial.pt
  37. historical article.pt
  38. or/67-69
  39. animal/
  40. human/
  41. 71 not (71 and 72)
  42. 66 not 70
  43. 74 not 73

Identify economic studies (strategy adapted from that of Centre for Reviews and Dissemination).

  1. 32 and 75

Identifies cardiac rehabilitation economic studies.

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