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Heart, lung & circulation
Dec, 2021;30 (12): 1891-1900.

The Role of Lifestyle and Cardiovascular Risk Factors in Dropout From an Australian Cardiac Rehabilitation Program. A Longitudinal Cohort Study.

Angela Rao, Robert Zecchin, Karen Byth, A Robert Denniss, Louise D Hickman, Michelle DiGiacomo, Jane L Phillips, Phillip J Newton
Author Information
  1. Angela Rao: Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia; Calvary Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia. Electronic address: angela.rao@uts.edu.au.
  2. Robert Zecchin: Western Sydney Local Health District, Sydney, NSW, Australia.
  3. Karen Byth: Western Sydney Local Health District, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia.
  4. A Robert Denniss: Western Sydney Local Health District, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia; Western Sydney University, Sydney, NSW, Australia.
  5. Louise D Hickman: Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
  6. Michelle DiGiacomo: Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
  7. Jane L Phillips: Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
  8. Phillip J Newton: Western Sydney University, Sydney, NSW, Australia.
PMID: 34219025 DOI: 10.1016/j.hlc.2021.05.103

Abstract

BACKGROUND: Cardiac rehabilitation (CR) programs reduce the risk of further cardiac events and improve the ability of people living with cardiovascular disease to manage their symptoms. However, many people who experience a cardiac event do not attend or fail to complete their CR program. Little is known about the characteristics of people who drop out compared to those who complete CR.
AIMS: To identify subgroups of patients attending a cardiac rehabilitation program who are more likely to dropout prior to final assessment by (1) calculating the dropout rate from the program, (2) quantifying the association between dropout and socio-demographic, lifestyle, and cardiovascular risk factors, and (3) identifying independent predictors of dropout.
METHODS: The study population is from a large metropolitan teaching hospital in Sydney, Australia, and consists of all participants consecutively enrolled in an outpatient CR program between 2006 and 2017. Items assessed included diagnoses and co-morbidities, quality of life (SF-36), psychological health (DASS-21), lifestyle factors and physical assessment. Dropout was defined as failure to complete the outpatient CR program and post CR assessment.
RESULTS: Of the 3,350 patients enrolled in the CR program, 784 (23.4%; 95%CI: 22.0-24.9%) dropped out prior to completion. The independent predictors of dropout were smoking (OR 2.4; 95%CI: 1.9-3.0), being separated or divorced (OR 2.0; 95%CI: 1.5-2.6), younger age (<55 years) (OR 1.9; 95%CI: 1.6-2.4), obesity (OR 1.6; 95%CI: 1.3-2.0), diabetes (OR 1.6; 95%CI: 1.3-2.0), sedentary lifestyle (OR 1.3; 95%CI: 1.1-1.6) and depressive symptoms (OR 1.3; 95%CI: 1.1-1.6).
CONCLUSION: To improve the CR program completion rate, clinicians need to consider the impact of socio-demographic, lifestyle, and cardiovascular risk factors on their patients' ability to complete CR. Tailored strategies which target the independent predictors of dropout are required to promote adherence to CR programs and thereby potentially reduce long-term cardiovascular risk.

Keywords

Cardiac rehabilitation Depression Obesity Sedentary behaviour

MeSH Term

Australia
Cardiac Rehabilitation
Cardiovascular Diseases
Heart Disease Risk Factors
Humans
Life Style
Longitudinal Studies
Middle Aged
Quality of Life
Risk Factors
Journal Article
Article has an altmetric score of 7

Word Cloud

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