Patient Characteristics Predictive of Cardiac Rehabilitation Adherence

Abstract

Purpose Cardiac rehabilitation (CR) is a program of structured exercise and interventions for coronary risk factor reduction that reduces morbidity and mortality following a major cardiac event. Although a dose response relationship between number of CR sessions completed and health outcomes has been demonstrated, adherence with CR is not high. In this study we examined associations between number ofsessions completed within CR and patient demographics, clinical characteristics, smoking status, and socioeconomic status (SES). Methods Multiple LogisticRegression and Classification and Regression Tree (CART) modeling were used to examine associations between participant characteristics measured at CR intake and number of sessions completed in a prospectively collected CR clinical database (N=1658). Results Current smoking, lower-SES, non-surgical diagnosis, exercise-limiting comorbidities, and lower age independently predicted fewer sessions completed. The CART analysis illustrates how combinations of these characteristics (i.e., risk profiles) predict number of sessions completed. Those with the highest-risk profile for non-adherence (less than 65 years old, current smoker, lower-SES) completed on average 9 sessions while those with the lowest-risk profile (greater than 72 years old, not current smoker, higher-SES, surgical diagnosis) completed on average 27 sessions. Conclusions Younger individuals, as well as those who report smoking, economic challenges, or have a non-surgical diagnosis, may require additional support to maintain CR session attendance.

Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

“…Our analysis showed that socioeconomic disadvantage is an important correlate of adherence to PR. Similar results have been reported for cardiac rehabilitation, with patients of lower socioeconomic status and current smokers attending three times fewer sessions than patients without such risk factors (39). In our study, patient characteristics predictive of lowest adherence to PR were White race, smoking, and low baseline functional capacity, which may be indicative of health-related barriers to following the exercise regimen.…”

Symptoms of depression are associated with physical inactivity but not modified by gender or the presence of a cardiovascular disease; a cross-sectional study

“…And finally, in the secondary prevention group were more smokers than in the primary prevention group. Smoking has previously been reported as inconsistently related to inactivity among CVD patients [20, 42], but is associated with increased symptoms of depression levels [19]. Smoking was therefore also treated as a potential confounder in the analysis.…”

An Exploration of the Impact of the “Open Gym” Scheduling Model of Cardiovascular Rehabilitation on Completion, Attendance, and Health Outcomes

“…Patient factors, such as socioeconomic status, depression, age, gender, and race are consistently strong predictors of CR engagement (number of sessions attended and completion rates). 1–4 These factors could be impacted by a more flexible scheduling model that could minimize barriers such as transportation issues and time limitations that are also predictive of poorer program engagement. 3–6 For example, a recent qualitative systematic review and meta-analysis of patient barriers to CR engagement concluded that scheduling was a major factor due to transportation issues and competing social and occupational demands, especially among women.…”