Strategies to improve adherence to exercise-based phase II cardiac rehabilitation after percutaneous coronary...

To identify, appraise, and synthesize the best available evidence on strategies to improve adherence to exercise-based phase II cardiac rehabilitation in patients after percutaneous coronary intervention, and to provide evidence-informed guidance for clinical practice.

Guided by the 6S evidence pyramid, a systematic search was conducted across evidence-based resources, guideline repositories, professional association websites, and primary literature databases for studies addressing strategies to improve adherence to exercise-based phase II cardiac rehabilitation after percutaneous coronary intervention. The search covered the period from database inception to November 30, 2025. Two reviewers independently screened the literature, appraised methodological quality using design-specific tools, and synthesized the evidence according to the Joanna Briggs Institute evidence grading and recommendation system.

A total of 24 studies were included, comprising 1 clinical decision support resource, 6 guidelines, 6 systematic reviews and meta-analyses, 6 expert consensus statements, 4 randomized controlled trials, and 1 quasi-experimental study. Thirty-two evidence statements were synthesized across seven dimensions: program referral and initiation, multidisciplinary cardiac rehabilitation team, individualized exercise prescription, adherence-enhancing interventions, population-specific strategies, social support, and quality management and outcome evaluation.

This study synthesized the best available evidence on strategies to improve adherence to exercise-based phase II cardiac rehabilitation in patients after percutaneous coronary intervention. The findings provide an evidence-informed basis for clinical practice and may support healthcare professionals in developing context-sensitive rehabilitation strategies to enhance patient participation and sustained engagement in phase II cardiac rehabilitation.

Evidence-Based Nursing Center of Fudan University. Registration number ES20257186.