MedicalResearch.com Interview with:
Lauren Cooper, MD
Fellow in Cardiovascular Diseases
Duke University Medical Center
Duke Clinical Research Institute
Medical Research: What is the background for this study?
Dr. Cooper: The HF-ACTION study, published in 2009, showed that exercise training is associated with reduced risk of death or hospitalization, and is a safe and effective therapy for patients with heart failure and reduced ejection fraction. Subsequently, Medicare began to cover cardiac rehabilitation for patients with heart failure. However, many patients referred to an exercise training program are not fully adherent to the program. Our study looked at psychosocial reasons that may impact participation in an exercise program.
Medical Research: What are the main findings?
Dr. Cooper: We found that patients with higher levels of social support and fewer barriers to exercise exercised more than patients with lower levels of social support and more barriers to exercise. And patients who exercised less had a higher risk of cardiovascular death or heart failure hospitalization compared to patients who exercised more.
Medical Research: What should clinicians and patients take away from your report?
Dr. Cooper: Exercise training improves outcomes in heart failure patients, thus clinicians should assess for factors that may limit a patient’s ability to participate in an exercise program and realize the full benefits of this therapy. Recognizing problems with social support and identifying potential barriers to exercise can help patients and family members work together to overcome these barriers.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Cooper: Future studies should assess whether exercise programs that incorporate personalized strategies to reduce patient perceived barriers to exercise training may translate into improved psychosocial factors, exercise adherence, and clinical outcomes.
L. B. Cooper, R. J. Mentz, J.-L. Sun, P. J. Schulte, J. L. Fleg, L. S. Cooper, I. L. Pina, E. S. Leifer, W. E. Kraus, D. J. Whellan, S. J. Keteyian, C. M. O’Connor. Psychosocial Factors, Exercise Adherence, and Outcomes in Heart Failure Patients: Insights From Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION). Circulation: Heart Failure, 2015; 8 (6): 1044 DOI:10.1161/CIRCHEARTFAILURE.115.002327
Lauren Cooper, MD (2015). Social Barriers Limit Benefits of Exercise in Heart Failure Patients