Perceptions of Cardiac Specialists and Rehabilitation Programs Regarding Patient Access to Cardiac Rehabilitation and Referral Strategies

Grace, Sherry L.; Tan, Yongyao; Simpson, Chris; Chessex, Caroline

doi:10.1097/hcr.0b013e31824e2df2

Cited by 15 publications

(26 citation statements)

References 10 publications

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“…73 Initiation of CR referral by clinicians as part of a comprehensive discharge order is the most commonly used strategy among 71 CR specialists in a Canadian study. 23 Providing CR information to patient at the bedside by allied health clinicians is the second most commonly used strategy. 23 Besides the liaison type of referral strategy (discussion about CR with an allied health clinician and the patient), an automatic referral system has shown the potential to increase CR referral.…”

Section: Discussionmentioning

confidence: 99%

“…23 Providing CR information to patient at the bedside by allied health clinicians is the second most commonly used strategy. 23 Besides the liaison type of referral strategy (discussion about CR with an allied health clinician and the patient), an automatic referral system has shown the potential to increase CR referral.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the reasons for non-referral were diverse and included: (1) patients' refusal; (2) distance; (3) patients resided in a long-term care facility; (4) unable to ambulate; (5) dementia or cognitive impairment; (6) complex health issues and/or palliative;(7) lack of transportation; (8) return to work, (9) psychiatric co-morbidities; and (10) language barriers. 23 While, these results should be interpreted with caution due to the low response rate, it is clear that an interplay of factors is occurring.…”

Section: Clinicians' Knowledgementioning

confidence: 99%

“…19 Cardiology residents, fellows and cardiologists also had better knowledge scores about CR programs and eligibility criteria and were more familiar with CR referral guidelines. 28 Similarly, cardiologists, cardiac surgeons and cardiac interns exhibit high levels of knowledge of the benefits of CR, 23 but there referral rates were still moderate at 65.932.0% of eligible patients (Table 1). Clearly other factors may be influential.…”

Section: Clinicians' Knowledgementioning

confidence: 99%

“…Furthermore, while policy may specify who should be referred to CR, local availability of resources, including exercise equipment, space for exercise, education sessions and sufficient staffing for screening, promotion and assessment, may influence prioritising of patients for referral. 23 This may manifest in an explicit policy about CR referral, or such understanding may be implicit. Likely influencers of implicit understanding may include clinician's values related to who will benefit from CR or who will 'fit' the program available., the purpose of this review is to synthesise the literature in relation to clinician attitudes, values and beliefs and their effect on CR referral and participation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and participation

Gallagher

Neubeck

et al. 2016

Eur J Prev Cardiolog

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinicians' Knowledgementioning

confidence: 99%

Section: Clinicians' Knowledgementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and participation

Gallagher

Neubeck

et al. 2016

Eur J Prev Cardiolog

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Cardiac Rehabilitation Adherence: Another Gender-Treatment Paradox

Sedlak

Humphries

2016

Canadian Journal of Cardiology

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See article by Oosenbrug et al., pages 1316e1324 of this issue.Cardiovascular disease remains the leading cause of death in North America with a higher rate of morbidity and mortality in women than in men. 1 After an acute coronary syndrome (ACS), women are more likely than men to die, particularly women younger than the age of 55 years who present with an ST-elevation myocardial infarction. 2,3 Further, women with an ACS suffer from delays in diagnosis and treatment, 4 undergo less invasive management, 5,6 receive less medical therapy, 7 and have higher complication rates such as bleeding, than do men. 8,9 Finally, women have lower socioeconomic status, quality of life, and exercise capacity than their male counterparts. 10 Cardiac rehabilitation (CR) is an outpatient chronic disease management program that encompasses patient education, dietary advice, structured and supervised exercise training, and risk factor assessment and modification after a cardiac event. There are >200 CR rehabilitation programs in Canada; 3 of which also offer women-only programs. 11 Research suggests there are many benefits to CR including reduced morbidity and mortality, improved functional status, improved quality of life, and cost savings for society and the economy. [12][13][14][15] The benefits appear similar in men and women, with some studies suggesting greater mortality reduction in women compared with men, particularly in those with good program adherence. 16 Unfortunately, despite the well known benefits of CR, enrollment rates are low, particularly in women. 17,18 In this issue, Oosenbrug et al. 19 performed a meta-analysis on CR adherence in men and women and quantitatively assessed sex differences in adherence. The mean age was 61 years and women accounted for only 27.3% of participants. The mean duration of CR programs was 15 weeks with a mean frequency of sessions of 2.5 per week. Overall, the mean

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Enhancing Participation in Cardiac Rehabilitation: A Question of Proximity and Integration of Outpatient Services

Ozemek¹,

Phillips

Fernhall³

et al. 2018

Current Problems in Cardiology

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Perceptions of Cardiac Specialists and Rehabilitation Programs Regarding Patient Access to Cardiac Rehabilitation and Referral Strategies

Abstract: Some of the least frequently used referral strategies were perceived as, and are also empirically demonstrated to be, most effective. Broader implementation of these strategies, while better-resourcing CR programs, may improve the continuum of care for cardiac patients.

Cited by 15 publications

References 10 publications

Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and participation

Facilitating or getting in the way? The effect of clinicians' knowledge, values and beliefs on referral and participation

Cardiac Rehabilitation Adherence: Another Gender-Treatment Paradox

Enhancing Participation in Cardiac Rehabilitation: A Question of Proximity and Integration of Outpatient Services

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