Physician factors affecting cardiac rehabilitation referral and patient enrollment: a systematic review

Area of Science:

• Cardiology
• Healthcare Management
• Medical Education

Background:

• Cardiac rehabilitation (CR) offers significant benefits but suffers from low enrollment rates.
• Physician-related factors are recognized as a barrier to patient participation in CR.
• Understanding these physician factors is crucial for improving CR access.

Purpose of the Study:

• To systematically review and synthesize existing literature on physician factors influencing CR referral and enrollment.
• To identify key physician characteristics and behaviors associated with CR participation.

Main Methods:

• A systematic literature search was conducted across major medical and psychological databases (MEDLINE, PsycINFO, CINAHL, Embase, EBM) up to October 2011.
• Seventeen relevant studies were included after independent review by two authors.
• Study quality was assessed using the Downs and Black criteria; no randomized controlled trials were identified.

Main Results:

• Medical specialty, with cardiac specialists referring more often, was linked to CR referral.
• Physician-reported reasons for referral and physician sex also showed associations with referral.
• Physician endorsement, specialty, referral status, and attitudes toward CR influenced patient enrollment.

Conclusions:

• Physician factors consistently play a role in both CR referral and patient enrollment.
• Leveraging physician endorsement strategies can enhance patient enrollment in cardiac rehabilitation.
• Further research and interventions should focus on optimizing the physician's role in CR promotion.