Construction of a comprehensive program for improving physical function for patients with cardiovascular disease in an aging society

Abstract

Aging populations and lifestyle diseases, like atherosclerosis, heart disease and diabetes, are rising in Japan. Japan's situation represents a case study for the problems facing many wealthy nations. Fortunately, physicians in Japan are developing new approaches to address this problem and there is hope that a change in perspective of patient care can improve while simultaneously reducing the burdens on healthcare providers and infrastructure. Dr Kazuhiro P. Izawa, a physiotherapist and researcher at the Kobe University, Graduate School of Health Sciences, often sees patients who, once diagnosed with a heart condition, begin to suffer from a lack of physical function and physical activity. From here, further conditions involving orthopaedics, metabolism and even cognitive function can manifest due to this lack of activity. 'The maintenance or improvement of physical function and physical activity is related to life prognosis of patients with heart disease as well as health-related quality of life. In addition, attention to recently sedentary behaviour in relation to health outcomes, such as diabetes, cardiovascular and cancer, is also needed,' observes Izawa. Therefore, according to him, a wider view of patients with conditions of the heart or elderly patients was needed; a view that didn't focus only on the symptoms of a single condition but saw a patient's lifestyle and living condition as part of the solution. He has also focused ways of assessing the interconnected factors, termed health utility, that contribute to quicker cardiac rehabilitation following onset or after surgery. 'Health utility, which can be assessed by several preference-based utility measures, is an important measure in the analysis of cost effectiveness in health care,' he says. These types of measures will become increasingly important as populations age and health care resources are stretched further and further.