Factors Associated With Failure to Complete Phase II Cardiac Rehabilitation: Survey Registry in Rajaie Cardiovascular Medical and Research Center

Moradi, Bahieh; Esmaeilzadeh, Maryam; Maleki, Majid; Sari, Leila

doi:10.5812/icrj.4370

Cited by 14 publications

(13 citation statements)

References 20 publications

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“…Employment status is often defined in a variety of ways, most commonly employed–unemployed comparisons are made sometimes including a third group; such as retired [14]. In the UK CR population the mean age of males is 66 years and females is 70 years, with approximately two thirds of population reported as being retired [6]. As such this study will include three employment groups; employed, unemployed and retired.…”

Section: Methodsmentioning

confidence: 99%

Relationship between employment and mental health outcomes following Cardiac Rehabilitation: an observational analysis from the National Audit of Cardiac Rehabilitation

Harrison

Sumner

McMillan

et al. 2016

International Journal of Cardiology

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BackgroundEmployment status has been shown to impact mental health state and intervention outcomes, yet still to be studied in a Cardiac Rehabilitation (CR) population. This observational study investigated the relationship between employment status and mental health outcomes following Cardiac Rehabilitation (CR).MethodsAll patients with an eligible cardiovascular incident entered into the National Audit of Cardiac Rehabilitation (NACR) 1 January 2013–31st December 2015. Logistic regression comparing the association between employment status and normal mental health categories.ResultsA total of 24,242 CR patients with completed post CR assessments were included and had representative age and gender distribution (mean 65 years, 73.2% male). At baseline the unemployed status had a lower proportion of patients in normal healthy categories than other groups (T-test and chi-squared p = < 0.05). The regression analyses revealed no significant association between retired and employed groups and outcome. There was significant association between unemployed patients and all mental health outcomes except anxiety; all p values < 0.05 and odds ratios between 0.525 and 0.772 showing less likelihood of achieving the normal healthy category.ConclusionsThis is the first UK study, using routinely collected data, to investigate in coronary heart disease patients the impact of employment status on outcomes. The findings were that when weighted for baseline differences, unemployed patients mostly had poorer outcomes. Teams involved in CR delivery should take particular care when interpreting mental health baseline measures when setting CR goals, especially in relation to unemployed patients, and efforts should be made in providing more patient tailored interventions.

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Section: Methodsmentioning

confidence: 99%

Relationship between employment and mental health outcomes following Cardiac Rehabilitation: an observational analysis from the National Audit of Cardiac Rehabilitation

Harrison

Sumner

McMillan

et al. 2016

International Journal of Cardiology

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“…Despite the advantages and effectiveness of the CR program, the results of prior investigations show that the participation rate in CR programs is low and the dropout rate is high [ 7 8 9 ]. Iran is not an exception to this rule; the results of one study [ 10 ] show that only 15% of cardiac patients participate in CR programs and 68.7% of those patients leave before program completion [ 11 ]. Thus, in Iran, only 5% to 6% of patients complete outpatient CR programs.…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic Predictors in Failure to Complete Outpatient Cardiac Rehabilitation

et al. 2015

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ObjectiveTo investigate the role of sociodemographic factors in failure to complete outpatient cardiac rehabilitation (CR).MethodsThis was a retrospective study that used information obtained from the database of the cardiac rehabilitation department of a cardiac hospital in Iran. Data from 1,050 CR patients treated at the hospital between January 2001 and January 2013 was analyzed using binary logistic regression analysis.ResultsOnly 49% of the patients completed the CR program. After adjustment for baseline variables, it was found that the following were significantly associated with failure to complete the CR program: illiteracy (p<0.001), old age (p<0.001), being an employee or retired (p<0.05), having a low capacity for exercise (p<0.001), depression (p<0.001), low anxiety (p<0.001), and not currently being a smoker (p<0.001).ConclusionPaying more attention to older patients with low literacy levels and limited exercise capacity, who are employed or retired, and who are not current smokers, and taking therapeutic measures to control psychological complications such as depression, may be effective in ensuring that patients complete outpatient cardiac rehabilitation.

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“…In middle-income countries, women are similarly less represented than men (<30%) in CR. 73,75,100,101 Indeed in one CR study in Brazil, there were no women represented. 102 Given there is no evidence that these vulnerable groups derive less clinical benefit from CR, these disparities suggest that some vulnerable groups have even less access to CR than does the average patient.…”

Section: Disparities In Patient Access To Crmentioning

confidence: 99%

Global availability of cardiac rehabilitation

2014

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The most prevalent non-communicable disease globally, namely cardiovascular disease (CVD), is also the leading cause of mortality, with over 80% of the deaths occurring in low-and middleincome countries. To lessen the impact of CVDs on individuals and societies, a comprehensive approach is needed. Cardiac rehabilitation (CR) involves delivery of structured exercise, education and risk reduction, in a cost-effective manner. Robust evidence demonstrates it reduces mortality up to 25%, improves functional capacity, as well as decreases re-hospitalization. Despite its benefits, and clinical practice guideline recommendations to refer cardiac patients, CR programs are grossly under-used. Worldwide, there is low availability of CR; only 38.8% of countries globally have CR programs. Specifically, 68.0% of high-income and 23% of LMICs (28.2% for middle-and 8.3% for low-income countries) have CR. CR density estimates ranged from 1 program per 0.1-6.4 million inhabitants. CR availability is much lower than that of other evidencebased secondary prevention therapies, such as revascularization and pharmacological therapies. Multi-level strategies to augment CR capacity and availability at national and international levels such as supportive public health policies, systematic referral strategies, and alternative models of delivery are needed.

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Factors Associated With Failure to Complete Phase II Cardiac Rehabilitation: Survey Registry in Rajaie Cardiovascular Medical and Research Center

Cited by 14 publications

References 20 publications

Relationship between employment and mental health outcomes following Cardiac Rehabilitation: an observational analysis from the National Audit of Cardiac Rehabilitation

Relationship between employment and mental health outcomes following Cardiac Rehabilitation: an observational analysis from the National Audit of Cardiac Rehabilitation

Sociodemographic Predictors in Failure to Complete Outpatient Cardiac Rehabilitation

Global availability of cardiac rehabilitation

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