Determinants of participation in cardiac telerehabilitation during the first surge of COVID-19.

BACKGROUND: Participation rates in cardiac rehabilitation (CR) are low. In multiple trials, telerehabilitation (TR) has been demonstrated to be effective. Still, real-life evidence is scarce. During the first surge of the COVID-19 pandemic our centre deployed a TR programme. This study aimed to characterise the patient population that had, for the first time, the opportunity to participate in cardiac TR and to analyse if there were determining factors for participation or non-participation in TR. METHODS: All patients enrolled in CR in our centre during the first wave of the COVID-19 pandemic were included in this retrospective cohort study. Data was collected from the hospital electronic records. RESULTS: 369 patients were contacted in the setting of TR. 69 patients could not be reached and were excluded from further analysis. 208 (69%) patients that were contacted agreed to participate in cardiac TR. No significant differences in baseline characteristics were seen between TR participants and TR non-participants. A full model logistic regression did not reveal any significant determinants on participation rate in TR. CONCLUSION: This study demonstrates that the rate of participation in TR was high (69%). Of the analysed characteristics, none was directly correlated with the willingness to participate in TR. Further research is needed to further assess determinants, barriers and facilitators of TR. Also, research is needed on better delineating digital health literacy and on how to reach also those patients that are less motivated and or less digitally literate.

Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines.

Until 2019, the European Association of Urology guidelines recommended the implantation of a penile prosthesis as a third-line therapy, which has since then changed to "if other treatments fail or depending on the patient's preference". Primary endpoint was to assess whether patients with a penile prosthesis and their partner would have preferred earlier implantation. Secondary endpoints were the reason why patient and partner wanted earlier implantation, how much earlier they wanted it, satisfaction of patient and partner and if patient and partner would have recommended the intervention. We selected patients with a virgin inflatable penile prosthesis operated between April 2013 and December 2019. We included 155 patients and 65 partners. Telephonic interview was conducted in a structured manner. Further data were collected retrospectively. The preference for earlier implantation was reported in 59.4% of patients and 46.2% of partners. Of them, respectively 53.2% and 46.6% would have wanted the prosthesis more than 5 years earlier. Satisfaction was seen in 83.2% of patients and 73.8% of partners. Respectively 82.6% and 78.4% of patients and partners would recommend the procedure. Our results indicate that a more patient-oriented approach with good counseling is desirable and that the "three-level" concept must be abandoned.