Self-reported disease management knowledge by cardiac rehabilitation use multinationally and its correlates

To multinationally investigate: (1) CVD management knowledge following CR, including variations by region, country income classification, as well as patient sociodemographic and clinical characteristics; (2) the association of post-CR knowledge with the number of CR sessions completed and setting of CR delivery; and (3) whether domain-specific knowledge post-CR is associated with corresponding health markers.

Secondary analysis of the International Council of Cardiovascular Prevention and Rehabilitation's International Cardiac Rehabilitation Registry (ICRR) data to December 2024 was conducted for this prospective observational study. Eligible patients were those receiving phase II outpatient CR, with pre-program assessment completed ≥ 6 months prior. Knowledge was assessed via patient report at follow-up/post-program in 9 domains (yes/no), as well as heart-health behaviors and work status. Programs reported CR use, functional capacity, and risk factors.

4309 patients from 17 programs in 11 countries were included, with 3359 (78.0%) having knowledge follow-up data. Total knowledge was high (8.1 ± 1.3), highest regarding return to life roles, cardiac medications, and care plans. In an adjusted regression model, knowledge varied by region, country income, work status, function, quality of life and CR completion. Knowledge in specific domains was associated with corresponding health markers, including nutrition (p < 0.001), medication adherence (p < 0.001), and stress (p = 0.009).

CR participants in diverse settings multinationally reported high disease management knowledge, with significant variation by regional, economic, and patient-level factors. Increased CR exposure, potentially in hybrid models, was associated with higher knowledge. This may be associated with improved health behaviors, and hence potentially better patient outcomes.

There is a need for tailored, evidence-based education strategies that address specific knowledge gaps and accommodate diverse patient populations.