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Patient preferences for cardiac rehabilitation and desired program elements
1Department of Internal Medicine, University of Michigan, Ann Arbor 48106-0363, USA.
Background:
Data evaluating the efficacy of traditional cardiac rehabilitation programs to meet patient needs are limited. The authors studied patient-perceived preferences in cardiac rehabilitation programs and desired program elements to evaluate differences by gender or age.
Methods:
The authors surveyed 199 patients (136 men, 60.0 +/- 11.6 years; 63 women, 63.7 +/- 12.7 years; P = 0.045) discharged from a tertiary referral hospital with acute myocardial infarction. Participants completed a standardized questionnaire regarding enrollment in rehabilitation and preferences for six program types on a 10-point scale (1 = little or no agreement, 10 = strongly agree).
Results:
In this study, 54.3% of subjects enrolled in cardiac rehabilitation. Older patients (> or = 65 years) were more likely to enroll in home-based programs compared with younger patients (< 65 years) (11.8% versus 1.4%, P = 0.02). Younger patients preferred a short-term rehabilitation facility more than older patients (7.4 +/- 3.5 versus 5.1 +/- 4.1 units on the 10-point scale, P = 0.001), and rated the following more favorably than older patients: local health club programs (6.2 +/- 3.7 versus 4.5 +/- 4.0, P = 0.01), long-term programs (6.5 +/- 3.8 versus 4.9 +/- 4.2, P = 0.02), and comprehensive programs (6.6 +/- 3.7 versus 4.9 +/- 2.2, P = 0.02). Younger patients rated the following program elements more favorably compared with older patients: stress management (7.0 +/- 3.5 versus 5.7 +/- 4.1, P = 0.04), vocational counseling (5.1 +/- 3.9 versus 1.9 +/- 2.4, P = 0.001), and smoking cessation (4.9 +/- 4.4 versus 2.7 +/- 3.4, P = 0.001).
Conclusions:
Program preferences differed significantly by age, but not gender. Older patients enrolled in home-based programs over clinic-based programs. Younger patients rated stress management, vocational counseling, and smoking cessation more favorably than older patients. Strategies to enhance patient participation in cardiac rehabilitation should incorporate patient age and preferences for program types and elements.