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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Published on: April 19, 2019

Are cardiac rehabilitation pathways influenced by diabetes: A cohort study

Birgitte Bitsch Gadager¹, Lars Hermann Tang², Patrick Doherty³

¹Centre for Rehabilitation Research, Department of Public Health, Aarhus University, Aarhus, Denmark; DEFACTUM, Central Denmark Region, Aarhus, Denmark.

International Journal of Cardiology

|June 16, 2024

Insights

Patients with diabetes are less likely to enroll in cardiac rehabilitation (CR) after acute coronary syndrome (ACS). Increased support is needed to improve CR uptake for diabetic patients following ACS.

Area of Science:

Cardiology
Diabetology
Public Health

Background:

Cardiac rehabilitation (CR) is recommended for acute coronary syndrome (ACS) patients.
Diabetes is a common comorbidity in ACS patients, but their participation in CR is understudied.
Identifying barriers to CR in ACS patients with diabetes is crucial for equitable care.

Purpose of the Study:

To examine referral, uptake, and completion rates of CR for ACS patients with and without diabetes.
To identify potential disparities and barriers within the CR pathway for diabetic ACS patients.

Main Methods:

Retrospective study of ACS patients (≥18 years) discharged between September 2017 and August 2018 in the Central Denmark Region.
Diabetes status determined from three data sources.
Logistic regression analysis to assess the association between diabetes and non-referral, non-uptake, and non-completion of CR, reported as odds ratios (OR) with 95% confidence intervals (CI).

Main Results:

Of 2447 eligible ACS patients, 18.7% had diabetes.
Diabetes was significantly associated with non-uptake of CR (OR = 1.38, 95% CI 1.01-1.90).
No statistically significant associations were found for non-referral (OR = 1.11, 95% CI 0.87-1.41) or non-completion (OR = 1.06, 95% CI 0.73-1.53) between diabetic and non-diabetic ACS patients.

Conclusions:

A significant disparity exists in CR uptake among ACS patients with diabetes.
Diabetic ACS patients require enhanced promotion and support to facilitate CR enrollment.
Addressing these barriers is essential for improving CR accessibility and outcomes for all ACS patients.

Read full analysis

Abstract

Background:

Cardiac rehabilitation (CR) is recommended following acute coronary syndrome (ACS). Diabetes is a common long-term condition associated with ACS, and the inclusion of these patients in CR has been less studied. This study examines the referral, uptake, and completion rates in the CR pathway for ACS patients with and without diabetes to identify potential barriers in the CR pathway.

Methods:

The study included patients aged 18 or above who were discharged after a diagnosis of ACS in the Central Denmark Region between 1 September 2017 and 31 August 2018. Diabetes information was obtained from three sources. Logistic regression models were used to examine the associations between having diabetes and the three outcomes: non-referral, non-uptake and non-completion. Results were reported as odds ratios (OR) with 95% confidence intervals (CI).

Results:

A total of 2447 patients were eligible for the study, of which 457 (18.7%) had diabetes. Only non-uptake was found to be significantly associated with diabetes after adjustment for prespecified variables (OR = 1.38, 95% CI 1.01-1.90). Associations for non-referral (OR = 1.11, 95% CI 0.87-1.41) and non-completion (OR = 1.06, 95 %CI 0.73-1.53) were not found to be statistically significant between ACS patients with diabetes and those without diabetes.

Conclusion:

This study highlights a significant disparity in the uptake of CR between patients with and without diabetes following ACS, demonstrating that patients with diabetes require early promotion and increased assistance to enrol in CR.

Keywords:

Acute Coronary Syndrome Cardiac rehabilitation Diabetes

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