Interventions to promote patient utilization of cardiac rehabilitation: Cochrane systematic review and meta-analysis

Pio, C. S. d. A., Chaves, G., Davies, P., Taylor, R. and Grace, S. (2019) Interventions to promote patient utilization of cardiac rehabilitation: Cochrane systematic review and meta-analysis. Journal of Clinical Medicine, 8(2), 189. (doi: 10.3390/jcm8020189) (PMID:30764517) (PMCID:PMC6406265)

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Abstract

Too few patients utilize cardiac rehabilitation (CR), despite its benefits. The Cochrane review assessing the effectiveness of interventions to increase CR utilization (enrolment, adherence, and completion) was updated. A search was performed through July 2018 of the Cochrane and MEDLINE (Medical Literature Analysis and Retrieval System Online) databases, among other sources. Randomized controlled trials in adults with myocardial infarction, angina, revascularization, or heart failure were included. Interventions had to aim to increase utilization of comprehensive phase II CR. Two authors independently performed all stages of citation processing. Following the random-effects meta-analysis, meta-regression was undertaken to explore the impact of pre-specified factors. Twenty-six trials with 5299 participants were included (35.8% women). Low-quality evidence showed an effect of interventions in increasing enrolment (risk ratio (RR) = 1.27, 95% confidence interval (CI) = 1.13–1.42). Meta-regression analyses suggested that the intervention deliverer (nurse or allied healthcare provider, p = 0.02) and delivery format (face-to-face, p = 0.01) were influential in increasing enrolment. There was low-quality evidence that interventions to increase adherence were effective (standardized mean difference (SMD) = 0.38, 95% CI = 0.20–0.55), particularly where remotely-offered (SMD = 0.56, 95% CI = 0.36–0.76). There was moderate-quality evidence that interventions to increase program completion were effective (RR = 1.13, 95% CI = 1.02–1.25). There are effective interventions to increase CR utilization, but more research is needed to establish specific, implementable materials and protocols, particularly for completion.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Creator Roles:
Taylor, R.Conceptualization, Methodology, Formal analysis, Project administration
Authors: Pio, C. S. d. A., Chaves, G., Davies, P., Taylor, R., and Grace, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Journal of Clinical Medicine
Publisher:MDPI
ISSN:2077-0383
ISSN (Online):2077-0383
Published Online:05 February 2019
Copyright Holders:Copyright © 2019 by the authors
First Published:First published in Journal of Clinical Medicine 8(2):189
Publisher Policy:Reproduced under a Creative Commons license

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