Rehabilitation Assessment and Intervention to Facilitate Return to Work in Coronary Artery Disease Patients: A Narrative Review

Abstract

Introduction: Coronary artery disease (CAD), causes significant changes in a person's life and is often accompanied by complex emotional reactions which further cause a decrease in the ability to complete work responsibilities, lower wages, and increase the risk of early dismissal. Promoting a return to work (RTW) program after CAD will improve economic burdens and the quality of life. This review aimed to explore the RTW program in CAD patients focused on the impact of CAD on the patients’ ability to back to their previous work and rehabilitation management to fulfill RTW criteria.

Methods: Articles published in the last 10 years based on PubMed and Google Scholar databases were reviewed narratively. Keywords used were “coronary artery diseaseâ€, “ischemic heart diseaseâ€, “cardiovascular diseaseâ€, “cardiac rehabilitationâ€, “return to workâ€, and “return to vocational activityâ€.

Results: The impact of CAD on RTW includes a decrease in the ability to RTW and work performance as well as an increase in the risk of premature dismissal. Factors that influence the RTW ability in CAD patients are sociodemographic, psychosocial, cardiovascular risk, medical history, complications during hospitalization, and clinical characteristics. Efforts to facilitate this process involve a wide range of assessments and interventions. The RTW ability can be determined through objective assessment of cardiac function, including exercise capacity and left ventricular ejection fraction, the presence or absence of comorbidities, job satisfaction, and other assessments of general well-being. Interventions aimed at promoting RTW consist of an initial CR (phase II CR) and an extended CR program.

Conclusion: The rehabilitation assessments and interventions given to patients with CAD have shown good results for RTW rates and the quality of work.