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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Factors related to non-adherence to cardiac rehabilitation in patients with heart failure
J Betancourt-Peña1, I Portela-Pino2, M Amaral-Figueroa3
1Facultad de Salud y Rehabilitación, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia; Facultad de Salud, Escuela de Rehabilitación Humana Universidad del Valle, Cali, Colombia; Universidad de Vigo, Vigo, Spain.
Insights
Low adherence to cardiac rehabilitation in heart failure patients is linked to high blood pressure, high LDL, high triglycerides, low functional capacity (DASI), and depression (PHQ-9). Addressing these factors can improve participation in these vital programs.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Public Health
Background:
- Cardiac rehabilitation is recommended for heart failure patients to improve outcomes.
- Low adherence rates to cardiac rehabilitation programs remain a significant challenge.
- Identifying factors influencing adherence is crucial for optimizing patient care.
Purpose of the Study:
- To determine factors associated with non-adherence to cardiac rehabilitation in heart failure patients in Colombia.
- To analyze the relationship between sociodemographic, clinical, functional, and psychological variables and adherence.
- To provide evidence for targeted interventions to improve cardiac rehabilitation uptake.
Main Methods:
- Observational, retrospective study involving 300 heart failure patients in a Colombian clinic.
- Adherence defined as attending ≥80% of scheduled cardiac rehabilitation sessions.
- Data collected included sociodemographics, clinical variables, functional capacity (Sit to Stand, 6-minute walk test), Duke Activity Status Index (DASI), quality of life (MLFHQ), and depression (PHQ-9).
Main Results:
- Adherence to cardiac rehabilitation was 66.67%.
- Significant differences were found between adherent and non-adherent groups in hypertension, LVEF, cholesterol, LDL, triglycerides, blood pressure, functional capacity (VO2e, METs, DASI), and depression (PHQ-9).
- Logistic regression identified arterial hypertension (OR 2.23), LDL above goals (OR 2.15), triglycerides above goals (OR 2.34), DASI < 4 METs (OR 2.38), and PHQ-9 score (OR 1.06) as predictors of non-adherence.
Conclusions:
- High blood pressure, elevated LDL and triglycerides, low functional aerobic capacity (DASI), and depression (PHQ-9) are key factors associated with non-adherence to cardiac rehabilitation in heart failure patients.
- These findings highlight the need for comprehensive assessments and tailored strategies to enhance patient engagement in cardiac rehabilitation.
- Interventions should address comorbidities and psychological factors to improve adherence and long-term outcomes for heart failure patients.
Introduction:
In heart failure, cardiac rehabilitation has been recommended as an intervention strategy that improves functional capacity, health-related quality of life and survival. However, adherence to these programs is low. The objective was to determine the factors related to non-adherence to cardiac rehabilitation in patients with heart failure in Colombia.
Method:
Observational and retrospective study. Patients with heart failure were linked in a clinic in Colombia, adherence to cardiac rehabilitation was measured with ≥80% of scheduled sessions. Sociodemographic and clinical variables, functional aerobic capacity (Sit to Stand and 6-minute walk test), Duke Activity Status Index (DASI), quality of life Minnesota Living with Heart Failure Questionnaire (MLFHQ) and depression Patient health questionnaire 9 (PHQ-9) were taken into account.
Results:
300 patients were linked with heart failure with age 63.16 ± 12.87 men 194 (64.7%). adherence to cardiac rehabilitation was 66.67%, there were statistically significant differences between the groups in arterial hypertension, LVEF, cholesterol, LDL, Triglycerides, SBP, DBP, distance traveled, VO2e, METs, DASI and PHQ-9 p-value =<0.05. The logistic regression model adjusted for sex and age showed OR for non-adherence to CR arterial hypertension 2.23[1.22-4.07], LDL outside of goals 2.15[1.20-3.88], triglycerides outside goals 2.34[1.35-4.07], DASI<4METs 2.38 [1.04-5.45] and PHQ-9 1.06[1.00-1.12].
Conclusion:
High blood pressure, LDL, triglycerides, DASI and depression with the PHQ-9 questionnaire are related factors for not having adherence to cardiac rehabilitation in patients with heart failure.
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