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Cardiac rehabilitation II: referral and participation
Sherry L Grace1, Susan E Abbey, Zachary M Shnek
1University Health Network Women's Health Program, Toronto, Ontario, Canada. sherry.grace@uhn.on.ca
Insights
Cardiac rehabilitation (CR) improves outcomes after ischemic coronary events (ICEs). Higher income, anxiety, and self-efficacy predicted CR participation, but fewer women were referred, highlighting disparities in secondary prevention.
Area of Science:
- Cardiology
- Psychosocial Health
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality and morbidity.
- Secondary prevention, including cardiac rehabilitation (CR), is crucial for improving outcomes after ischemic coronary events (ICEs).
- Understanding factors influencing CR referral and participation is vital for optimizing patient recovery.
Purpose of the Study:
- To examine the relationship between psychosocial factors and CR referral and participation.
- To identify predictors of CR participation six months post-ICE.
- To explore potential disparities in CR access and engagement, particularly for women.
Main Methods:
- Prospective study of 906 patients (586 men, 320 women) post-ICE.
- Data collected over six months from coronary intensive care unit (CICU) patients.
- Logistic regression analysis used to identify predictors of CR participation, controlling for sociodemographics.
Main Results:
- Only 30% of patients were referred to CR programs.
- Significantly fewer women than men were referred to CR.
- Higher family income, greater anxiety, and higher self-efficacy predicted CR participation at six months.
Conclusions:
- Psychosocial factors, income, and self-efficacy influence CR participation after an ICE.
- Disparities in CR referral, especially for women, require attention.
- Targeted interventions may improve CR uptake and outcomes for diverse patient populations.
Abstract:
Cardiovascular disease (CVD) is the leading cause of death and disability for women and men. Substantial health risks continue following ischemic coronary events (ICEs), but secondary prevention efforts, including cardiac rehabilitation (CR), have beneficial effects on both early and late mortality and morbidity. This prospective study examined the relationship among psychosocial factors and CR referral and participation patterns in 906 (586 men, 320 women) patients from the coronary intensive care unit (CICU) over the course of six months. Only 30% of participants were referred to CR programs, with significantly fewer women being referred. A logistic regression analysis was used to determine whether depression, anxiety, self-efficacy, or social support predicted CR participation six months following an ICE, while controlling for sociodemographic factors. Results show that higher family income, greater anxiety symptomatology, and higher self-efficacy were significantly predictive of CR participation at six months. Implications for women's recovery from an ICE are discussed.