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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Factors Associated With Attendance at a 1-yr Post-Cardiac Rehabilitation Risk Factor Check
Justin D Giannoccaro1, Sandeep Aggarwal, Sherry L Grace
1TotalCardiology Rehabilitation, Calgary, Alberta, Canada (Mr Giannoccaro, Dr Aggarwal and Rouleau, and Ms Hauer); Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (Dr Aggarwal); Faculty of Health, York University, Toronto, Ontario, Canada (Dr Grace); Knowledge, Innovation, Talent, Everywhere (KITE), University Health Network, Toronto, Ontario, Canada (Dr Grace); Department of Psychology, University of Calgary, Calgary, Alberta, Canada (Drs Campbell and Rouleau); and Department of Physical Therapy, University of Illinois at Chicago (Dr Arena).
Insights
Patients often miss cardiac rehabilitation follow-ups due to perceived lack of necessity or practical issues. Strengthening recommendations and patient awareness can improve attendance for sustained cardiovascular health.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Coronary artery disease (CAD) patients struggle with long-term secondary prevention post-cardiac rehabilitation (CR).
- Low attendance at 1-year follow-up visits after CR hinders sustained health behavior maintenance.
- Understanding barriers to these crucial follow-ups is essential for improving patient outcomes.
Purpose of the Study:
- To explore patient characteristics and barriers associated with nonattendance at a 1-year follow-up visit after completing cardiac rehabilitation.
- To identify factors influencing patient decisions to attend or miss post-rehabilitation appointments.
Main Methods:
- A survey was administered to 45 CAD patients who completed CR but missed their 1-year follow-up.
- The survey included open-ended questions, the Cardiac Rehabilitation Barriers Scale, and items on health practices and perceived recommendation strength.
- Thematic analysis and linear regression were used to analyze barriers and associated characteristics.
Main Results:
- Key barriers included lack of awareness, perception of the appointment as unnecessary, practical/scheduling issues, comorbid health problems, and anticipation of an unpleasant experience.
- Higher self-reported barriers were significantly associated with a lower perceived strength of recommendation to attend the follow-up.
Conclusions:
- Enhancing the perceived importance and recommendation strength for follow-up visits is crucial.
- Improving patient awareness, highlighting benefits, and supporting self-efficacy may increase attendance.
- Increased attendance can support long-term adherence to cardiovascular risk reduction behaviors.
Purpose:
Patients with coronary artery disease (CAD) often fail to maintain secondary prevention gains after completing cardiac rehabilitation (CR). Follow-up appointments aimed at assessing cardiac status and encouraging maintenance of health behaviors after CR completion are generally offered but not well-attended. This study explored patient characteristics and barriers associated with nonattendance at a 1-yr follow-up visit following CR completion.
Methods:
Forty-five patients with CAD who completed a 12-wk outpatient CR program but did not attend the 1-yr follow-up appointment were included. Participants responded to a survey consisting of open-ended questions about follow-up attendance, a modified version of the Cardiac Rehabilitation Barriers Scale, and self-report items regarding current health practices and perceived strength of recommendation to attend. Thematic analysis was used to derive categories from open-ended questionnaire responses. Linear regression was used to assess characteristics associated with appointment attendance barriers.
Results:
Barrier themes were as follows: (1) lack of awareness; (2) perception of appointment as unnecessary; (3) practical or scheduling issues; (4) comorbid health issues; and (5) anticipated an unpleasant experience at the appointment. Greater self-reported barriers (mean ± SD = 1.97/5.00 ± 0.57) were significantly associated with lower perceived strength of recommendation to attend the follow-up appointment (2.82/5.00 ± 1.45), P = .005.
Conclusions:
Providing a stronger recommendation to attend, enhancing patient awareness, highlighting potential benefits, and supporting self-efficacy might increase 1-yr follow-up appointment attendance and, in turn, support long-term adherence to cardiovascular risk reduction behaviors.
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