Social Determinants and Patient Characteristics Predict Cardiac Rehabilitation Uptake and Adherence

Gallagher, R.; Neubeck, L.; Davis, A.; Redfern, J.; Parker, H.; Hyun, K.; Chow, C.; Celermajer, D.; Buckley, T.; Schumacher, T.; Toffler, G.; Figtree, G.

Abstract

Background
Cardiac rehabilitation is a well-established, evidence-based method to support secondary prevention and is recommended in acute coronary syndrome guidelines internationally. Despite this and systematic approaches to improve uptake, rates remain between 25-46% in Australia. Patient factors identified as influential include age, smoking status, diagnosis, depression and gender, however exercise-limiting factors (obesity and mobility limiting condition) and sociodemographic factors (education and English fluency) are rarely examined.
Aim
To determine the influence of health and social determinants on cardiac rehabilitation attendance.
Methods
A secondary analyses of the MyHeartMate trial participants (n=394) admitted for coronary heart disease. Cardiac rehabilitation is self-reported at 6-months, body mass index measured as recommended, clinical data from the medical record. Multiple logistic and linear regression analyses were used to determine independent associates of uptake and attendance.
Results
Participants were aged mean 61 (SD=11) years, 81% male; 274 completing the parent study and 184(46.9%) attended cardiac rehabilitation for a mean 9.65 (SD=5.98) sessions.
After adjusting for all factors included in the analyses, native English speakers (OR 2.06, 95%CI 1.02,4.16) were more likely to take up cardiac rehabilitation and patients with higher BMI (OR .94, 95%CI .89,.99) were less likely. Women attended fewer sessions than men (β=-2.471, 95%CI -4.83, -0.11), whereas those with at least one exercise limiting condition attended more sessions (β=3.93, 95%CI 1.27,6.6).
Conclusion
Additional support and adaptation of cardiac rehabilitation services are required to attract patients with less English fluency and obesity and to support women’s continued attendance.

Citation

Gallagher, R., Neubeck, L., Davis, A., Redfern, J., Parker, H., Hyun, K., Chow, C., Celermajer, D., Buckley, T., Schumacher, T., Toffler, G., & Figtree, G. (2024). Social Determinants and Patient Characteristics Predict Cardiac Rehabilitation Uptake and Adherence. Heart, Lung and Circulation, 33(suppl_4), S230. https://doi.org/10.1016/j.hlc.2024.06.216

• Journal Article Type: Other
• Online Publication Date: Jul 28, 2024
• Publication Date: 2024-08
• Deposit Date: Sep 3, 2024
• Journal: Heart, Lung and Circulation
• Print ISSN: 1443-9506
• Electronic ISSN: 1444-2892
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: suppl_4
• Pages: S230
• DOI: https://doi.org/10.1016/j.hlc.2024.06.216
• Public URL: http://researchrepository.napier.ac.uk/Output/3779858