Patterns of attendance at cardiac rehabilitation

We recently completed a study investigating participation in cardiac rehabilitation by patients attending the Royal Melbourne Hospital.

It is widely acknowledged that cardiac rehabilitation programs facilitate recovery from acute cardiac illness. Many studies have demonstrated the numerous benefits which patients gain through participating in such programs. These include improved quality of life, a reduced risk of further cardiac events and an earlier return to activities and work. In recent years, there has been a rapid growth in the number of available programs throughout Australia, especially in Victoria. Despite the reported benefits of these rehabilitation programs, however, many patients do not attend at all or drop out early after attending only one or two sessions.

A major study of attendance patterns at cardiac rehabilitation programs was therefore undertaken by the Heart Research Centre. Stage one of this study aimed to identify sociodemographic, medical and behavioural predictors of attendance and drop-out in a consecutive series of patients with acute cardiac events admitted to two Melbourne metropolitan hospitals. Patients were tracked four months later to ascertain whether or not they had attended a cardiac rehabilitation program during convalescence. Stage two of the study involved in depth interviews with 250 randomly selected patients to explore reasons for nonattendance and dropout. An important aim of this stage was to examine communication in hospital and after discharge between patients and health professionals regarding attendance at cardiac rehabilitation programs. Attitudes of patients and their spouses and their doctors towards the patients' attendance were also explored.

The project was conducted over three years involving 808 consecutively admitted patients to The Royal Melbourne Hospital and the Western Hospital. Baseline data were collected (mostly via a brief personal interview in hospital) from 808 patients consecutively admitted following heart attack or for coronary bypass surgery or coronary angioplasty. Findings from this study have been reported extensively. They should have important implications for practice. The ability to identify and predict patients who are likely to not attend or to drop out of cardiac rehabilitation programs will assist in improving discharge planning. Further, patient feedback about program inadequacies and doctors' involvement in promoting these programs should lead to better programs which meet patient needs more effectively.

Funding: Commonwealth Department of Health and Ageing under the National Health Goals and Targets Program