Background
Cardiac rehabilitation (CR) is an effective preventive measure that remains underutilised
in the United States. The study aimed to determine the CR referral rate (RR) after
percutaneous coronary intervention (PCI) at an academic tertiary care centre, identify
barriers to referral, and evaluate awareness of CR benefits and indications (CRBI)
among cardiologists. Subsequently, it aimed to evaluate if an intervention consisting
of physicians’ education about CRBI and implementation of a formal CR referral system
could improve RR and consequently participation rate (PR).
Methods
Data were retrospectively collected for all consecutive patients who underwent PCI
over 12 months. Referral rate was determined and variables were compared for differences
between referred and non-referred patients. A questionnaire was distributed among
the physicians in the Division of Cardiology to assess awareness of CRBI and referral
practice patterns.
After implementation of the intervention, data were collected retrospectively for
consecutive patients who underwent PCI in the following six months. Referral rate
and changes in PRs were determined.
Results
Prior to the intervention, RR was 17.6%. Different barriers were identified, but the
questionnaire revealed lack of physicians’ awareness of CRBI and inconsistent referral
patterns. After the intervention, RR increased to 88.96% (Odds Ratio 37.73, 95% CI
21.34-66.70, p<0.0001) and PR increased by 32.8% to reach 26%. Personal endorsement
of CRBI by cardiologists known to patients increased CR program graduation rate by
35%.
Conclusions
Cardiologists’ awareness of CRBI increases CR RR and their personal endorsement improves
PR and compliance. Education of providers and implementation of a formal referral
system can improve RR and PR.
Abbreviations:
CABG (Coronary artery bypass graft), CR (Cardiac rehabilitation), DM (Diabetes mellitus), GRMC (Georgia Regents Medical Center), MI (Myocardial infarction), PCI (Percutaneous coronary intervention)Keywords
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Article info
Publication history
Published online: February 20, 2015
Accepted:
February 6,
2015
Received:
January 12,
2015
Identification
Copyright
Published by Elsevier Inc.
