Factors affecting the uptake of cardiac rehabilitation services in a rural locality

Geographic issues in cardiac rehabilitation utilization: A narrative review

“…Table 1 summarizes nine studies (47.4% of all included findings) assessing rurality in relation to CR utilization (Harrison, Wardle 2005, Suaya et al 2007, King, Humen & Teo 1999, King et al 2001, Brady et al 2005, Johnson, Weinert & Richardson 1998, Higgins et al 2008, Smith, Harkness & Arthur 2006, Sundararajan et al 2004). Table 2 summarizes 10 studies (52.6% of all findings) which examined distance/travel time to CR (Ades et al 1992, Missik 2001, Suaya et al 2007, Yates, Braklow-Whitton & Agrawal 2003, Higgins et al 2008, Melville et al 1999, Grace et al 2008b, De Angelis, Bunker & Schoo 2008, Dunlay et al 2009, Brual et al 2010.…”

“…Most studies defined CR utilization as "attending at least one CR session". Only three studies (17.6%) distinguished between the effects of geographic barrier on CR enrollment versus level of participation (Harrison, Wardle 2005, Johnson, Weinert & Richardson 1998, Brual et al 2010. Of these, only one study (5.8%) assessed the impact of geographic issues on CR program completion (Harrison, Wardle 2005).…”

“…Overall, nine of the 17 (52.9%) studies identified reported a significant negative relationship between CR utilization and geographic indicators. However, four (23.5%) studies showed null effects (Harrison, Wardle 2005, Missik 2001, Melville et al 1999, Dunlay et al 2009), and four (23.5%) showed mixed findings (Suaya et al 2007, Johnson, Weinert & Richardson 1998, Higgins et al 2008, Brual et al 2010. With regard to the studies finding mixed results, two studies, specifically found geographic barriers were significantly and negatively associated with enrollment, but that they were not linked to the degree of CR participation once enrolled (Johnson, Weinert & Richardson 1998, Brual et al 2010.…”

“…Four studies found no association between geographic indicators and CR utilization (Harrison, Wardle 2005, Missik 2001, Melville et al 1999, Dunlay et al 2009). Two of these studies were conducted in the United Kingdom (UK) (Harrison, Wardle 2005, Melville et al 1999.…”

“…As shown in Table 1, of the nine studies which assessed rurality, five studies (55.6%) showed a significant negative relationship between rurality and CR utilization (King, Humen & Teo 1999, King et al 2001, Brady et al 2005, Smith, Harkness & Arthur 2006, Sundararajan et al 2004), two studies (22.2%) showed no relationship (Harrison, Wardle 2005, Higgins et al 2008, two studies (22.2%) showed mixed findings (Suaya et al 2007, Johnson, Weinert & Richardson 1998. One of these studies showed a significant positive relationship between rurality and CR utilization (Suaya et al 2007).…”