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Women and cardiac rehabilitation: referral and compliance patterns
Insights
Cardiac rehabilitation programs show gender disparities. While women are eligible, men have higher referral and completion rates for Phase II cardiac rehabilitation, highlighting a need for tailored programs.
Area of Science:
- Cardiology
- Public Health
- Gender Studies
Background:
- Heart disease remains a leading cause of death for American women.
- Disparities in referral and adherence to cardiac rehabilitation (CR) between male and female patients are documented.
- Understanding these gender-based differences is crucial for improving cardiovascular disease management.
Purpose of the Study:
- To explore the utilization of Phase I and Phase II cardiac rehabilitation programs by male and female patients.
- To investigate the relationship between eligibility, physician referral, and completion rates for Phase II CR in both genders.
- To identify reasons for nonparticipation in Phase II CR among patients who did not start the program.
Main Methods:
- Utilized structured patient interviews and chart audits.
- Assessed cardiac rehabilitation eligibility criteria, referral patterns, and completion rates.
- Sample included 87 patients (46 women, 41 men) with diagnoses including angina, myocardial infarction, and post-surgery.
Main Results:
- Men exhibited higher eligibility for Phase I CR, while women showed higher eligibility for Phase II CR.
- Physician referrals for Phase II CR were more common in men than in women.
- Men demonstrated higher completion rates for Phase II CR compared to women.
Conclusions:
- Despite similar eligibility, women are referred less often and complete Phase II CR at lower rates than men.
- Barriers to Phase II CR participation for women include transportation and insurance issues.
- Tailored CR programs addressing women's specific needs are essential to improve participation and outcomes.
Abstract:
Heart disease is the primary killer among American women. Differences in referral for cardiac rehabilitation, as well as compliance rates, have been reported between male and female cardiac patients. This study explored the use of Phase I and Phase II cardiac rehabilitation programs by male and female patients. In particular, the study aimed to investigate the relationship between eligibility and subsequent referral to Phase II cardiac rehabilitation in both men and women, as well as their compliance rates in completing Phase II. In addition, for those patients who never started a Phase II program, their reasons for nonparticipation were explored. Structured patient interviews and chart audits were used to explore cardiac rehabilitation eligibility criteria, referral and completion rates. The sample consisted of 87 patients (46 women and 41 men) who were admitted with a medical diagnosis of angina, myocardial infarction, coronary artery bypass grafting, or valve replacement surgery. Men had higher eligibility rates for Phase I, whereas women had higher eligibility rates for Phase II; more men received a referral for Phase II from their physician than women did. Men had a higher completion rate with Phase II compared with women. For those patients who chose not to start a Phase II program, the most common reasons cited included transportation problems, insurance issues, and having exercise equipment at home. Although women are being referred for cardiac rehabilitation, fewer complete the programs. Continued education is essential to teach women the importance of cardiac rehabilitation to overall recovery and adaptation to an acute cardiac event. In addition, cardiac rehabilitation programs must be structured to meet the unique needs of women and thereby remove obstacles that have prevented higher participation rates by women in the past.