Research and Clinical Interests

The overall aim of Reid's research is to improve the quality and efficiency of chronic disease prevention and management programs. Over the past 10 years, his research group has focused on three main themes: 1) developing systematic approaches to smoking cessation in hospitalized smokers; 2) promoting exercise and physical activity in patients with heart disease; and 3) examining the effectiveness and cost-efficiency of different models of delivering cardiac rehabilitation and secondary prevention services. More recently, the group has taken on the challenge of how best to reduce risk and prevent heart disease in the family members of patients with diagnosed heart disease.

The Ottawa Model for Smoking Cessation

Hospitalization provides a unique opportunity to identify and engage smokers, initiate cessation treatments and facilitate appropriate follow-up and support. Reid's research group has developed a systematic approach to the identification, treatment and follow-up of hospitalized smokers, now known as the Ottawa Model for Smoking Cessation (OMSC). The OMSC has now been adopted by more than 50 hospitals across Canada, and Reid's team oversees the centralized database that tracks long-term outcomes in these programs. Implementation of the OMSC is associated with an approximate doubling in the odds of successful long-term cessation compared to usual care.

The Tracking Exercise After Cardiac Hospitalization (TEACH) Study

The Tracking Exercise After Cardiac Hospitalization (TEACH) Study examined patterns and predictors of physical activity behaviour in more than 800 patients with heart disease. This study is unique because it included not only people who participate in cardiac rehabilitation (where most of the exercise literature in cardiac populations comes from) but also people who choose not to participate. Reid and his colleagues found that physical activity levels initially increase rapidly after hospitalization and then decline over time starting at about two months after hospitalization. Several factors were found to affect physical activity levels, including age, gender, co-morbidities (such as congestive heart failure and diabetes), activity level prior to hospitalization, type of revascularization, self-efficacy (belief in one's abilities) and home exercise equipment. Knowledge of these factors has been incorporated into the design of new interventions to promote physical activity in patients with heart disease.

The CardioFit Expert System for Exercise

One way that patients with heart disease could receive support and assistance for physical activity is via the Internet. Reid's group designed the CardioFit Internet-based expert system to prescribe and track exercise in patients with heart disease who were not participating in traditional cardiac rehabilitation. A randomized controlled trial showed that the CardioFit Expert System significantly increased objectively measured physical activity and heart disease health-related quality of life six months after randomization compared to usual care. The CardioFit program is now being offered as an option for patients discharged from the University of Ottawa Heart Institute.

Efficacy and Economic Evaluations of Different Models of Cardiac Rehabilitation

Secondary prevention through cardiac rehabilitation (CR) has been recommended for most patients with heart disease. Although generally reimbursed for three months, to date, optimal CR program duration and frequency of patient contact has yet to be identified. This study compared standard (33 sessions for three months) versus distributed (33 sessions for 12 months) CR. The data indicated that both groups showed improvements over time in cardiorespiratory fitness, daily physical activity, low-density lipoprotein cholesterol, generic and heart disease HRQL, and depressive symptoms. There were no clinically meaningful or statistically significant between-group differences for outcomes at 12 or 24 months. From a clinical standpoint, this study indicates that both standard and distributed program formats serve patients equally well over the longer term. Programs could use either program delivery model (standard or distributed) depending on patient or program needs. Costs to the cardiac health care system are similar.

Family Heart Health Study

Family members (spouses, siblings, offspring) of patients with coronary heart disease (CHD) may themselves be at increased risk for developing CHD for genetic, biochemical and/or behavioural reasons. Targeted approaches aimed at family members of those with established CHD may be a cost-effective way to identify high-risk persons and link them to effective risk factor modification. Reid's group has developed a 12-week family heart health program featuring a personal plan for achieving risk-factor goals and weekly contact with a heart health educator. Family members of patients previously hospitalized with CHD, identified through screening as having ≥ 1 modifiable risk factor for CHD, are currently being recruited for the study at the Heart Institute.