National Academies Press: OpenBook

Cardiovascular Disability: Updating the Social Security Listings (2010)

Chapter: Appendix B: Literature Review

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Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
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Appendix B
Literature Review

A review of the published literature related to disability was conducted to examine current evidence of cardiovascular conditions and employment capability. The primary strategy included database searches using keywords and Medical Subject Headings (MeSH), yielding initial results of 14,642 studies published between 1980 and October 2009. The studies were reviewed, analyzed, and coded according to a tiered category system. A secondary search strategy included a manual review of references cited in key articles as well as searches executed in PubMed using key terms. Final results included 35 relevant studies for detailed review. Topics of discussion among the relevant studies include frequency of returning to work following an acute myocardial infarction, physical disability in populations with peripheral artery disease, and the impact of job strain and depressive symptoms on return to work after acute coronary syndrome.

METHODS

The primary strategy of the literature review was to search four databases: Medline, EMBase, Web of Science, and PsychINFO. Together these databases contain information on research related to medicine, nursing, health care delivery, psychiatry, sociology, and psychology. Search strategies were developed for each database using text and MeSH terms in groups focused on each of the listing-level cardiovascular conditions (chronic heart failure, ischemic heart disease, recurrent arrhythmias, symptomatic congenital heart disease, heart transplant, aneurysm of the aorta and major branches, chronic venous insufficiency, and peripheral artery

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

disease) and seven separate evaluation sets: disability, employment, quality of life, functional capacity, treatment outcomes, severity of impairment, and comorbidities.

Unique terms were identified in each subject area to yield a wide array of results. Strategy parameters included limiting the search to human subjects, the English language, and publication years from 1980 to October 2009. This time period was chosen to ensure the most relevant studies were captured that examined employment capability of populations with cardiovascular conditions. For those evaluation sets reviewing functional capacity, treatment outcomes, and severity of impairment, the parameters were further limited to results published from 2004 to focus on the most recent medical and science literature.

The secondary strategy of the literature review involved reviewing key articles’ cited references. Additionally, the PubMed database was searched using Boolean logic with the main term of cardiovascular and key terms related to employment, that is, return to work. Studies were published from 1966 to 2009. Other literature supplemented the body of relevant research supporting the committee’s research and report writing, resulting from targeted searches performed on an ad hoc basis to answer specific research questions.

PRELIMINARY ANALYSIS AND RESULTS

A tiered category system was developed to refine results. A rigorous review of study titles and abstracts determined which studies met the inclusion criteria. Each study was coded according to the corresponding tier (see Box B-1). The primary search strategy yielded 85 studies in Tier 1; after removing duplicate articles produced from the primary search strategy, the secondary strategy yielded an additional 88 studies, for a total of 173 Tier 1 studies. To refine these results, the parameters were further limited to focus on studies published between 2004 and 2009, producing the final results of the literature review of 35 Tier 1 articles. Table B-1 provides a more detailed review of the final Tier 1 studies.

An additional 674 articles were identified as Tier 2 articles, which were reviewed to potentially inform the broader parameters affecting functional capacity of populations with cardiovascular diseases leading to disability. These parameters include relative quality of life (with specific measurements for health-related quality of life), comorbid conditions, gender comparisons, and assessments of treatments for cardiovascular conditions or associated conditions that may lead to disability or impairment. The committee determined the Tier 2 studies were not immediately relevant to the statement of work, and few of the studies were included in the final report. The remaining studies were categorized as Tier 3 and 4 studies. Tier 3 stud-

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

ies were available to inform background research during report writing as necessary. Tier 4 studies do not meet the inclusion criteria and were not included in the study process.

BOX B-1

Definition of Tiers

Tier 1: Studies on clinical measures of treatment outcomes, diagnostic techniques, or health status indicators as they relate to employment capability (i.e., return to work, employability) for populations with cardiovascular disease diagnoses that may lead to disability


Tier 2: Studies on one or more parameters of disability (e.g., comorbid conditions, quality of life, mortality) as they affect functional capacity for populations with cardiovascular conditions


Tier 3: Studies on disability or employment factors that do not explicitly address, measure, or estimate medical treatment or functional capacity of populations with cardiovascular conditions (i.e., studies on predictors of disease including employment status, job stress, or demographic values such as race, age, or gender)


Tier 4: Studies not related to cardiovascular disease disability and employment

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

TABLE B-1 Literature Table of Cardiovascular Employment and Disability Articles

Study

Study Type

Time Frame

Sample Size

Abbas, A. E., B. Brodie, G. Stone, D. Cox, A. Berman, S. Brewington, S. Dixon, W. W. O’Neill, and C. L. Grines. 2004. Frequency of returning to work one and six months following percutaneous coronary intervention for acute myocardial infarction. American Journal of Cardiology 94(11):1403–1405.

Observational

Unknown

900

Brisson, C., R. Leblanc, R. Bourbonnais, E. Maunsell, G. R. Dagenais, M. Vezina, B. Masse, and E. Kroger. 2005. Psychologic distress in postmyocardial infarction patients who have returned to work. Psychosomatic Medicine 67(1):59–63.

Observational

October 1995–November 1997

990

Crossland, D. S., S. P. Jackson, R. Lyall, J. Burn, and J. J. O’Sullivan. 2005. Employment and advice regarding careers for adults with congenital heart disease. Cardiology in the Young 15(4):391–395.

Observational

Unknown

299

Earle, A., J. Z. Ayanian, and J. Heymann. 2006. Work resumption after newly diagnosed coronary heart disease: Findings on the importance of paid leave. Journal of Women’s Health 15(4):430–441.

Observational

1996

289

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Telephone survey at 1- and 6-month follow-ups to determine rates of return to work in population of myocardial infarction patients who received percutaneous coronary intervention

Angiography; demographic and clinical characteristics; employment status pre-and post-acute myocardial infarction and percutaneous coronary intervention

51% of the study population returned to work within 1 month of the myocardial infarction. Predictors of early return to work included employment in the United States (study population was international), no history of smoking, and single-vessel coronary disease. At 6 months follow-up, 78% of the population had resumed work.

Psychiatric Symptom Index (French version)

Prevalence of psychologic distress in women and men after return to work post-myocardial infarction

Psychological distress is significantly more prevalent in return to work post-myocardial infarction patients versus general working population.

Questionnaire

Severity of disease; rates of employment; rates of receiving career advice and education

Receiving career advice was associated with return to work and maintaining employment among study participants.

Cardiac survey; employment status; bivariate chi-square and logistic regression analyses

New diagnosis of myocardial infarction or angina in the 2 years prior; health condition/behavior; severity of condition; social support; demographic characteristics

79% of women return to work after myocardial infarction or angina. Women with paid leave are more likely to return to work. Indicators of a severity of health condition (i.e., myocardial infarction or participation in cardiac rehabilitation) reduced the likelihood of return to work. Higher socioeconomic status and more education increased likelihood of employment.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Ellis, J. J., K. A. Eagle, E. M. Kline-Rogers, and S. R. Erickson. 2005. Perceived work performance of patients who experienced an acute coronary syndrome event. Cardiology 104(3):120–126.

Observational

July 1999–November 2002

158

Ezekowitz, J. A., D. S. Lee, J. V. Tu, A. M. Newman, and F. A. McAlister. 2008. Comparison of one-year outcome (death and rehospitalization) in hospitalized heart failure patients with left ventricular ejection fraction > 50% versus those with ejection fraction < 50%. American Journal of Cardiology 102(1):79–83.

Observational

April 1999–March 2001

9,943

Farkas, J., K. Cerne, M. Lainscak, and I. Keber. 2008. Return to work after acute myocardial infarction—Listen to your doctor! International Journal of Cardiology 130(1): e14-e16.

Observational

1999–2002

74

Fonarow, G. C., W. G. Stough, W. T. Abraham, N. M. Albert, M. Gheorghiade, B. H. Greenberg, C. M. O’Connor, J. L. Sun, C. W. Yancy, J. B. Young, and OPTIMIZE-HF 2007. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure—A report from the OPTIMIZE-HF registry. Journal of the American College of Cardiology 50(8):768–777.

Observational

Unknown

41,267

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Mailed survey to patients discharged from university-affiliated hospital with diagnosis of acute coronary syndrome during a 3-year period

Health status (SF-8, PCS-8, MCS-8, EQ-5D), cardiac function status (Duke Activity Status Index), symptom count, comorbidity index, patient-perceived cardiac disease severity, medication count and compliance, job satisfaction, current employment duration, patient demographics, acute coronary syndrome type

Current employment is associated with higher work performance post acute coronary syndrome event.

Discharge medication compared with outcome measures

Rehospitalization or mortality within 1 year

ACE inhibitors, spironolactone, and statins are associated with better outcomes in patients with heart failure who have been hospitalized.

Questionnaire

Physical, sociodemographic, psychological factors; return to work following myocardial infarction

Controlling for other variables, only physicians’ advice was associated with return to work.

Web-based registry; Pearson chi-square test and Wilcoxon test analyses

Preserved systolic function if ejection fraction documented as ≥ 40% or qualitatively normal or mildly impaired; left ventricular systolic dysfunction if ejection fraction < 40% or moderate/ severe left ventricular dysfunction by qualitative assessment

ACC/AHA performance measure application: adherence to measures more frequent with left ventricular systolic dysfunction; influence of pharmacologic therapy: preserved systolic function—no relationship with beta-blocker or ACE inhibitor, left ventricular systolic dysfunction and beta-blocker experienced significantly lower risk all-cause mortality at 60-to 90-day follow-up.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Fonarow, G. C., W. T. Abraham, N. M. Albert, W. G. Stough, M. Gheorghiade, B. H. Greenberg, C. M. O’Connor, K. Pieper, J. L. Sun, C. Yancy, and J. B. Young. 2007. Association between performance measures and clinical outcomes for patients hospitalized with heart failure. Journal of the American Medical Association 297(1):61–70.

Observational

March 2003–December 2004

5,791

Fukuoka, Y., K. Dracup, M. Takeshima, N. Ishii, M. Makaya, L. Groah, and E. Kyriakidis. 2009. Effect of job strain and depressive symptoms upon returning to work after acute coronary syndrome. Social Science & Medicine 68(10):1875–1881.

6-month prospective longitudinal study

January 2004–March 2006

240

Geyer, S., K. Norozi, R. Buchhorn, and A. Wessel. 2009. Chances of employment in women and men after surgery of congenital heart disease: Comparisons between patients and the general population. Congenital Heart Disease 4(1):25–33.

Observational

April 2003–January 2004

314

Grady, K. L., P. M. Meyer, D. Dressler, C. White-Williams, A. Kaan, A. Mattea, S. Ormaza, S. Chillcott, A. Loo, B. Todd, M. R. Costanzo, and W. Piccione. 2003. Change in quality of life from after left ventricular assist device implantation to after heart transplantation. Journal of Heart & Lung Transplantation 22(11):1254–1267.

Observational

August 1994–August 1999

40

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Multivariable and propensity-adjusted analyses to assess process-outcome relationship for each performance measure

Rehospitalization or mortality rates 60 to 90 days post-discharge

Current heart failure performance measures have little relationship with patient mortality and hospitalization in 60–90 days post-discharge.

Follow-up at 3 and 6 months; mailed written questionnaires; BDI-II; Job Content Questionnaire; Duke Activity Status Index

Job strain/characteristics; Beck Depression Inventory II

Even mild depressive symptoms were a strong predictor of delay or failure to return to work.

Examined relationship between disease severity and employment status

Classification by type of surgery (curative, reparative, palliative) as indicator of disease severity; classified by New York Heart Association system

Likelihood of full-time employment decreases as disease severity increased.

Quality of Life Index, Rating Question Form, Heart Failure Symptom Checklist, Sickness Impact Profile, Left Ventricular Assist Device (LVAD) Stressor Scale, Heart Transplant Stressor Scale, Jalowiec Coping Scale

Quality of life at 3 months post-LVAD versus 3 months post-heart transplant

Patients were significantly more satisfied with quality of life after heart transplantation compared with LVAD; mobility, self-care, physical ability, and overall functioning were more improved in transplant group

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Grady, K. L., D. C. Naftel, J. K. Kirklin, C. White-Williams, J. Kobashigawa, J. Chait, J. B. Young, D. Pelegrin, K. Patton-Schroeder, B. Rybarczyk, J. Daily, W. Piccione Jr., and A. Heroux. 2005. Predictors of physical functional disability at 5 to 6 years after heart transplantation. Journal of Heart and Lung Transplantation 24(12):2279–2285.

Observational

Unknown

311

Holper, E. M., J. Blair, F. Selzer, K. M. Detre, A. K. Jacobs, D. O. Williams, H. Vlachos, R. L. Wilensky, P. Coady, D. P. Faxon, Registry Percutaneous Transluminal Coronary Angioplasty, and Investigators Dynamic Registry. 2006. The impact of ejection fraction on outcomes after percutaneous coronary intervention in patients with congestive heart failure: An analysis of the National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry and Dynamic Registry. American Heart Journal 151(1):69–75.

Randomized controlled trial

July 1997–February 1998; February 1999–July 1999; October 2001–March 2002

4,697

Incalzi, R. A., A. Corsonello, C. Pedone, F. Corica, P. Carbonin, and R. Bernabei. 2005. Construct validity of activities of daily living scale: A clue to distinguish the disabling effects of COPD and congestive heart failure. Chest 127(3):830–838.

Observational

4 months, (unknown period)

1,271

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Sickness Impact Profile, Quality of Life Index, Heart Transplant Symptom Checklist, Jalowiec Coping Scale, Positive and Negative Affect Schedule-Expanded Form, Cardiac Depression Scale, Assessment of Problems with the Heart Transplant Regimen

Differences in physical functional disability at 5 to 6 years post-transplant; clinical data collected from hospital records, clinic charts, and the Cardiac Transplant Research Database

Physical functional disability was low at 5 to 6 years post-transplant; women had more overall physical functional disability; patients with comorbidities had more physical functional disability; and physical functional disability was related to activities of daily living.

Telephone interview by trained nurse assessing symptoms, medication status, and coronary event

Demographic; angiographic and lesion characteristics; patient-specific procedural data, outcomes (ejection fraction values)

Patients with chronic heart failure were older and were more often women and African Americans. They presented with history of prior myocardial infarction and revascularization, diabetes, hypertension, and other severe concomitant noncardiac disease; lower ejection fraction; more extensive coronary artery disease; higher frequency of triple-vessel disease and total occlusions; and higher mean number of significant lesions.

Construct validity for self-reported activities of daily living (ADLs) and instrumental activities of daily living (IADLs); surveys; questionnaires

Functional status prehospital admission compared with assessments of postdischarge; comparing chronic obstructive pulmonary disease (COPD) and diabetes mellitus

COPD is associated with a pattern of disability expressed by loss of select ADL/IADLs; with ADL/IADL cluster similar in two populations with different chronic conditions (e.g., chronic heart failure and diabetes mellitus); and crude lost IADL may not fully represent loss of personal independence.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Jalowiec, A., K. L. Grady, and C. White-Williams. 2007. Functional status one year after heart transplant. Journal of Cardiopulmonary Rehabilitation and Prevention 27(1):24–32. Erratum in: Journal of Cardiopulmonary Rehabilitation and Prevention 2007 27(3):165.

Observational

Unknown

237

Kiessling, A., and P. Henriksson. 2005. Perceived cognitive function in coronary artery disease—An unrecognized predictor of unemployment. Quality of Life Research 14(6):1481–1488.

Observational

2 years (unknown period)

169

Kuoppala, J., and A. Lamminpää. 2008. Rehabilitation and work ability: A systematic literature review. Journal of Rehabilitation Medicine 40(10):796–804.

Review

N/A

N/A

Lau-Walker, M. O., M. R. Cowie, and M. Roughton. 2009. Coronary heart disease patients’ perception of their symptoms and sense of control are associated with their quality of life three years following hospital discharge. Journal of Clinical Nursing 18(1):63–71.

Observational

3 years (unknown period)

253

Massie, B. M., J. J. Nelson, M. A. Lukas, B. Greenberg, M. B. Fowler, E. M. Gilbert, W. T. Abraham, S. R. Lottes, J. A. Franciosa, and Cohere Participant Physicians. 2007. Comparison of outcomes and usefulness of carvedilol across a spectrum of left ventricular ejection fractions in patients with heart failure in clinical practice. American Journal of Cardiology 99(9):1263–1268.

Observational

1 year (unknown period)

4,280

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Sickness Impact Profile; paired t-tests; medical and demographic data on patient questionnaire

Pre- and post-transplant functional scores from Sickness Impact Profile

1-year post-transplant predictors of worse functional status included greater symptom distress, more stressors, neurologic problems, depression, female gender, older age, and lower left ventricular ejection fraction (worse function).

Health-related quality of life questionnaires

Gainful employment and return to work in patients with coronary artery disease

Perceived cognitive function predicts both prevalence of unemployment and early retirement and sick leave due to coronary artery disease.

N/A

N/A

Vocational rehabilitation may help reduce absentee rates; concepts of workplace must be integrated into rehabilitation practices.

Questionnaires

SF-36 (physical and mental summary scores)

Coronary artery disease patients’ perception of their symptoms and sense of control at time of discharge was significantly associated with their quality of life 3 years postdischarge.

Comparing beta-blocker carvedilol, characteristics, carvedilol titration, and outcomes of patients according to left ventricular ejection fraction > 40% or < 40%

Patient status and clinical events provided at baseline, end-titration and 6 and 12 months thereafter; clinical events defined as hospitalizations, unscheduled visits

Patients with preserved ejection fraction were more likely to be older, female, and hypertensive; lower left ventricular ejection fraction was associated with worse functional class and more heart failure hospitalizations in the previous year.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

McBurney, C. R, K. A. Eagle, E. M. Kline-Rogers, J. V. Cooper, D. E. Smith, and S. R. Erickson. 2004. Work-related outcomes after a myocardial infarction. Pharmacotherapy 24(11):1515–1523.

Observational

7 months (unknown period)

89

Mital, A., A. Desai, and A. Mital. 2004. Return to work after a coronary event. Journal of Cardiopulmonary Rehabilitation 24(6):365–373.

Review

N/A

N/A

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Work-Performance Scale of the functional Status Questionnaire; health-related quality of life; Physical Component Summary (PCS-12)

Return to work post-myocardial infarction

Variables associated with not returning to work included past myocardial infarction, coronary artery bypass graft, heart failure, positive stress test, low score on the PCS-12 scale of the SF-12; patients who did not return to work also tended to have more comorbidities and take more prescribed drugs; median WPS scores were higher for patients who had higher ejection fraction at discharge, had not experienced a previous myocardial infarction, underwent a percutaneous revascularization intervention at the time of hospitalization, and had not recently been absent from work; and workers reporting absence from work had lower PCS-12 scores or reported rehospitalization.

N/A

N/A

Patients with coronary artery bypass graft indicate likelihood to return to work based on information other than cardiac findings: education level (higher, more likely), work history (high stress, less likely), gender (men, more likely), age (older, less likely), and psychological factors (depressive mood, less likely).

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

O’Connor, C. M., D. J. Whellan, K. L. Lee, S. J. Keteyian, L. S. Cooper, S. J. Ellis, E. S. Leifer, W. E. Kraus, D. W. Kitzman, J. A. Blumenthal, D. S. Rendall, N. H. Miller, J. L. Fleg, K. A. Schulman, R. S. McKelvie, F. Zannad, I. L. Pina, and HF-ACTION Investigators. 2009. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. Journal of the American Medical Association 301(14):1439–1450.

Randomized controlled trial

April 2003–February 2007

2,331

Paris, W., and C. White-Williams. 2005. Social adaptation after cardiothoracic transplantation: A review of the literature. Journal of Cardiovascular Nursing 20(Suppl 5): S67–S73.

Review

N/A

N/A

Petrucci, R. J., K. C. Truesdell, A. Carter, N. E. Goldstein, M. M. Russell, D. Dilkes, J. M. Fitzpatrick, C. E. Thomas, M. E. Keenan, L. A. Lazarus, N. D. Chiaravalloti, J. J. Trunzo, J. W. Verjans, E. C. Holmes, L. E. Samuels, and J. Narula. 2006. Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients. Annals of Thoracic Surgery 81(5):1738–1744.

Observational

January 1984–December 2002 (18 years)

252

Phillips, L., T. Harrison, and P. Houck. 2005. Return to work and the person with heart failure. Heart & Lung 34(2):79–88.

Review

N/A

N/A

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Multicenter randomized controlled trial; aerobic exercise training for patients with chronic heart failure

Rehospitalization; all-cause mortality

There were nonsignificant reductions in outcomes for primary group; authors propose reasons in the discussion; exercise training is associated with significant reductions for both all-cause mortality or hospitalization and cardiovascular mortality or heart failure hospitalization; exercise training was well tolerated and safe.

N/A

N/A

Describes social adaptation for heart, lung, and heart–lung transplant recipients; less than half of recipients who are physically able to work are employed; patients who do not resume working within first year less likely to return to work at all.

New York Heart Association Stage III to IV symptomatic left ventricular ejection fraction < 20% requiring frequent hospitalization for worse heart failure and neuropsychological exam

Memory, motor, and processing speed; neuropsychological exam

Cognitive deficits are common in advanced heart failure and worsen with increasing severity of heart failure.

N/A

N/A

Nurses may be a necessary and important advocate for patients with heart failure. Nurses should be available to assess, provide resources. Additional research is needed for safe transition for heart failure patients to workforce.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Poston, R. S., R. Tran, M. Collins, M. Reynolds, I. Connerney, B. Reicher, D. Zimrin, B. P. Griffith, and S. T. Bartlett. 2008. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Annals of Surgery 248(4):638–646.

Observational

January 2005–June 2007

200

Reynolds, M. W., D. Frame, R. Scheye, M. E. Rose, S. George, J. B. Watson, and M. A. Hlatky. 2004. A systematic review of the economic burden of chronic angina. American Journal of Managed Care 10(Suppl 11):S347–S357.

Review

N/A

N/A

Rollman, B. L., B. H. Belnap, M. S. LeMenager, S. Mazumdar, H. C. Schulberg, and C. F. Reynolds III. 2009. The Bypassing the Blues treatment protocol: Stepped collaborative care for treating post-CABG depression. Psychosomatic Medicine 71(2):217–230.

Randomized controlled trial

8 months (unknown period)

450

Ruel, M., A. Kulik, B. K. Lam, F. D. Rubens, P. J. Hendry, R. G. Masters, P. Bédard, and T. G. Mesana. 2005. Long-term outcomes of valve replacement with modern prostheses in young adults. European Journal of Cardiothoracic Surgery 27(3):425–433.

Observational

1976–2002

500

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Examine the efficacy of mini- versus standard-coronary artery bypass graft. Patients prescreened and interviewed 3- and 12-months post major adverse cardiac and cerebrovascular event (MACCE)

Patient satisfaction; post-operative clinical data; demographics

Mini-coronary artery bypass graft shortens patient recovery time, minimizes MACCE risk at 1 year, and shows superior quality and outcome metrics versus standard coronary artery bypass graft; there are higher return to work rates and/or normal activities in a significantly shorter period of time.

N/A

N/A

Chronic angina may require substantial costs caused by frequent hospitalizations and expensive revascularization procedures. Angina also causes substantial workplace productivity loss. Long-term and lasting improvement in work status is difficult to achieve.

300 patients with depressive symptoms post-coronary artery bypass graft (PHQ-9) and 100 nondepressed patients, measured by SF-36 Mental Component Summary score

Mood symptoms, cardiovascular morbidity, employment, health services use, and treatment costs

To be determined.

Primary valve replacement, either aortic or mitral

Mortality, stroke, bleeding events, reoperation, heart failure, other prosthesis-related complications, quality of life

Late outcomes of modern prosthetic valves in young adults remain suboptimal; bioprostheses deserve consideration in the aortic position, as mechanical.

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Study

Study Type

Time Frame

Sample Size

Vohra, R. S., P. A. Coughlin, and M. J. Gough. 2007. Occupational capacity following surgical revascularization for lower limb claudication. European Journal of Vascular and Endovascular Surgery 34(6):709–713.

Observational

February 2001–February 2005

139

White-Williams, C., A. Jalowiec, and K. Grady. 2005. Who returns to work after heart transplantation? Journal of Heart & Lung Transplantation 24(12):2255–2261.

Observational

Data collection ended in 1997

237

Suggested Citation:"Appendix B: Literature Review." Institute of Medicine. 2010. Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: The National Academies Press. doi: 10.17226/12940.
×

Methodology

Outcome Measures

Relevant Findings

Questionnaires

Employment status after procedure (lower limb revascularization)

Two-thirds of potentially employable patients with claudication return to work following surgery. Factors influencing decision to return to work include age, type of procedure, and preoperative occupation.

Work history tool, rating question form, heart transplant stressor scale, quality of life index, Sickness Impact Profile, Jalowiec Coping Scale, social support index, heart transplant symptom checklist, and chart review form; frequency distributions, chi-square, t-tests, and stepwise regression analysis

Work history, quality-of-life outcomes collected at time of enrollment and 1-year post-transplant; functional status measured with the Sickness Impact Profile; Heart Transplant Stressor Scale developed for this study measures perceived stressful nature of issues related to HF and transplant; Quality of Life and Jalowiec Coping Scale measure patient life satisfaction and coping mechanisms

81% of participants maintained employment status post-transplant. Those who did not work prior to transplant did not work post-transplant. Those who worked before surgery maintained employment after surgery. Twenty-one patients returned to work post-transplant, on average resuming work 4.8 months post-surgery. Ejection fraction did not differ significantly among those working and those not working. Those who returned to work were mostly white-collar, business/executive employees; those who did not return to work included mostly sales clerks, technicians, and factory workers.

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The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

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