Bustamante, María José and Valentino, Giovanna and Krämer, Verónica and Adasme, Marcela and Guidi, Dominique and Ibara, Camila and Casasbellas, Cinthia and Orellana, Lorena and Fernández, Marcelo and Navarrete, Carlos and Acevedo, Mónica (2015) Patient Adherence to a Cardiovascular Rehabilitation Program: What Factors Are Involved? International Journal of Clinical Medicine, 06 (09). pp. 605-614. ISSN 2158-284X
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Abstract
Background: Phase II cardiac rehabilitation (CR) is a class IA indication in patients suffering a cardiovascular event (CV). Current guidelines suggest 36 exercise sessions over a period of 3 months. The main aim of this study was to analyze the rate of adherence to a cardiac rehabilitation program and the factors influencing it. Methods: This was a cross-sectional study in 421 secondary prevention patients, who assisted to a Phase-II-CR program between 2007 and 2014. At baseline and program end, patients completed a 6-minute walk test and the Short-Form 36 Health Survey (SF-36). Vital signs and anthropometric measurements were also collected. Adherence was quantified as the percentage of individuals who attended all 36 sessions of the program. Factors considered for affecting adherence included: cardiovascular risk factors (RFs), type of health insurance (public or private), aerobic capacity, and SF-36 score parameters. Results: Adherence to Phase-II-CR was 33%, with no significant differences between men and women. The regression model fully adjusted for age, sex, RFs, type of health insurance and SF-36 score, showed that a SF-36 score <50 on physical health (odds ratio (OR): 11.47; 3.99 - 32.99; p < 0.0001) and smoking (OR: 4.41; 1.25 - 15.62; p = 0.02) were strong predictors for non-adherence. A trend for better adherence was observed in subjects older than 50 years compared to those aged between 17 and 50 years (37% versus 23%, respectively; p = 0.05). No significant differences were observed in adherence according to RFs clustering. Conclusions: Adherence to Phase-II-CR is low in our population. Patient-related factors, such as SF-36 score and smoking, were the best determinants of Phase-II-CR adherence. Health system-related factors did not influence adherence in this population. Prospective studies are warranted to determine all the factors which may influence adherence to Phase-II-CR programs.
Item Type: | Article |
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Subjects: | Eurolib Press > Medical Science |
Depositing User: | Managing Editor |
Date Deposited: | 23 Feb 2023 06:37 |
Last Modified: | 04 Mar 2024 03:51 |
URI: | http://info.submit4journal.com/id/eprint/1183 |