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Earlier appointments increased initial cardiac rehabilitation participation
A cardiac rehabilitation appointment scheduled within 10 days of hospital discharge improved attendance at orientation and overall participation, researchers reported in Circulation.
National guidelines recommend a time interval from hospital discharge to cardiac rehabilitation of 1 to 4 weeks. Previous research indicate that time from discharge to enrollment in cardiac rehabilitation averages 35 days, according to background information in the study.
Quinn R. Pack
Quinn R. Pack, MD, of the division of cardiovascular medicine at Henry Ford Hospital in Detroit, and colleagues studied 148 patients (mean age, 60 years; 56% men; 49% black) at hospital discharge from Henry Ford Hospital who had a nonsurgical-qualifying diagnosis for cardiac rehabilitation. Those with a qualifying diagnosis had an MI, PCI or angina with an ischemic stress electrocardiogram, stress echocardiogram or stress myocardial perfusion imaging study.
Patients were randomly assigned to cardiac rehabilitation orientation within 10 days of discharge or at 35 days.
Median time to orientation for patients assigned early cardiac rehabilitation was 8.5 days compared with 42 days for patients assigned standard cardiac rehabilitation. Seventy-seven percent of patients assigned early cardiac rehabilitation attended the orientation session compared with 59% of the standard cardiac rehabilitation group. According to results, this resulted in an 18% absolute and 56% relative improvement (RR=1.56; 95% CI, 1.03-2.37). The researchers calculated a number needed to treat of 5.7.
Limited finances and loss of contact with the cardiac rehabilitation program were the two main reasons given for nonparticipation.
“We demonstrated that early appointments to cardiac rehabilitation within 10 days of hospital discharge are feasible and significantly improve participation in the free-of-charge orientation session held before starting exercise training,” the researchers said. “If such a system were implemented in other hospitals across the United States, it would likely have a favorable effect on initial participation in cardiac rehabilitation.”
Disclosure: Some of the researchers report financial ties with Janssen Healthcare Innovation.