Implementing Cardiac Rehabilitation as a First-Line Treatment for Stable Angina Pectoris: PERSPECTIVES OF...

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Health Services Research

Background:

• Cardiac rehabilitation (CR) is a potential alternative to revascularization for stable angina pectoris (SAP).
• Understanding implementation barriers and facilitators is crucial for optimizing CR use.
• Previous research has not fully explored clinician and patient perspectives on CR for SAP.

Purpose of the Study:

• To assess barriers and facilitators for implementing CR as a first-choice treatment for SAP.
• To identify clinician and patient perspectives on CR adoption.
• To inform strategies for improving CR accessibility for SAP patients.

Main Methods:

• Qualitative study involving interviews with 12 clinicians and 6 patients in the Netherlands.
• Analysis using the theoretical domains framework for inductive and deductive approaches.
• Exploration of perceived and expected barriers and facilitators to CR as a primary treatment.

Main Results:

• 44 barriers and 28 facilitators identified across 8 themes.
• Clinician barriers include lack of evidence, guideline ambiguity, knowledge gaps, perceived effort, lack of support, and organizational issues.
• Patient facilitators include openness to CR and trust in clinicians; no major patient barriers were reported.

Conclusions:

• Clinicians encounter significant barriers in proposing CR over revascularization for SAP.
• Enhanced evidence, guideline clarity, and professional association support are essential for CR implementation.
• Addressing clinician-reported barriers is key to making CR a preferred initial strategy for SAP.