Are patient characteristics and modes of delivery associated with completion of cardiac rehabilitation? A national registry analysis

Tang, L. H., Harrison, A., Skou, S. T., Taylor, R. S. , Dalal, H. and Doherty, P. (2022) Are patient characteristics and modes of delivery associated with completion of cardiac rehabilitation? A national registry analysis. International Journal of Cardiology, 361, pp. 7-13. (doi: 10.1016/j.ijcard.2022.05.007) (PMID:35533754)

Abstract

Aim: To achieve effectiveness and reduce inequality in everyday cardiac rehabilitation, this study aims to compare individual patient characteristics along with completion rates to traditional and evolving modes of delivery in cardiac rehabilitation. Method: Patients were included from the UK National Audit of Cardiac Rehabilitation (NACR) database. All patients with coronary heart disease (≥18 years) between the 1st of January 2014 to 31st of December 2019 that started core rehabilitation with a recorded mode of cardiac rehabilitation delivery were eligible. Modes of delivery were divided into: centre-based, home-based, and hybrid. Logistic regression models were used to investigate association between modes of delivery and completion adjusting for patient demographics. Result: In total 182,722 patients had mode of delivery recorded: 72.8% centre-based, 8.3% home-based and 18.9% hybrid. The home-based mode in comparison to hybrid and centre-based had significantly higher rates of females, single, white, and unemployed patients (p < 0.001). There was a higher proportion of cardiovascular risk factors in home-based than the other modes (p < 0.001). There was a reduced likelihood of completing home-based cardiac rehabilitation compared to centre-based with an odds ratio of 0.66, (95% CI: 0.48 to 0.91) but no significant difference between hybrid and centre-based modes (odds ratio, 1.18; 95% CI 0.92 to 1.51). Conclusions: From large real-world data, home-based modes of delivery appear to have significantly lower levels of completion than centre-based modes. Cardiac rehabilitation programs offering home-based and hybrid delivery modes need to be structured to ensure adequacy of completion.

• Item Type: Articles
• Additional Information: This study and the NACR data are funded by the British Heart Foundation grant (040/PSS/17/18/NACR). Dr. Tang, Dr. Harrison and Prof. Skou are currently funded by a grant from Region Zealand (Project: Exercise First). Dr. Tang is funded by Danish Regions and The Danish Health Confederation through the Development and Research Fund for financial support (project nr. 2703). Prof. Skou is funded by a grant from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement No 801790).
• Keywords: Completion, Self-delivery, Home-based, Hybrid, Cardiac disease, Rehabilitation
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Taylor, Professor Rod
• Authors: Tang, L. H., Harrison, A., Skou, S. T., Taylor, R. S., Dalal, H., and Doherty, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: International Journal of Cardiology
• Publisher: Elsevier
• ISSN: 0167-5273
• ISSN (Online): 1874-1754
• Published Online: 06 May 2022
• Copyright Holders: Copyright © 2022 Elsevier
• First Published: First published in International Journal of Cardiology 361:7-13
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher