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Irrational health beliefs linked to noncompliance with cardiac rehab
Patients who have a tendency to rely on beliefs not grounded in medical science, or irrational health beliefs, have a higher rate of premature discontinuation of cardiac rehabilitation, according to results of a new pilot study.
Derek R. Anderson, MA, and Charles F. Emery, PhD, from the department of psychology at The Ohio State University, investigated whether “irrational health beliefs” and depression are related to cardiac rehabilitation adherence. Previous research has demonstrated that such beliefs are linked to adherence in patients with diabetes.
“The Irrational Health Belief Scale (IHBS) was developed to measure health-related cognitive distortions that are not disease specific. IHBS items reflect beliefs based on nonmedical factors such as personal experience (eg, ‘If it didn’t work the first time, it probably never will in my case’), catastrophizing (eg, ‘If I have to take this medication, my life will never be the same’) and illogical inferences about treatment side effects (eg, ‘Something that makes me feel this tired can’t be any good for me’),” Anderson and Emery wrote.
According to the researchers, patients with greater irrational health beliefs may be more likely to make health-related decisions not based on medical evidence.
For this study, the researchers recruited 61 patients (29.5% women; mean age, 59.9 years; 72% white) at the outset of the outpatient cardiac rehabilitation program at The Ohio State University Medical Center. Conditions for which the study population was referred to cardiac rehabilitation included PCI (41%), history of MI (20%), CHD (20%) or recent CABG (19%).
Participants were analyzed based on the proportion of cardiac rehabilitation sessions completed and measures of depression and irrational health beliefs surveyed at baseline, including the Center for Epidemiologic Studies Depression Scale and the IHBS.
Anderson and Emery found that irrational health beliefs predicted the percentage of cardiac rehabilitation sessions completed, even after controlling for age, race/ethnicity and income (P<.05).
“We believe the results underscore the importance of providing patients with evidence in support of the benefits of [cardiac rehabilitation] early in the process of [cardiac rehabilitation] and/or at the time of referral to [cardiac rehabilitation],” Emery told Cardiology Today.
In addition, older age and higher income were associated with better adherence to cardiac rehabilitation (P<.05 for both), and adherence was lower among blacks than whites (P<.01).
Depression was not related to adherence (P=.78).
“Identifying and targeting predictors of [cardiac rehabilitation] nonadherence may provide an opportunity for intervening among individuals at greater risk of nonadherence,” Anderson and Emery wrote. “These results suggest that targeting patients with higher levels of irrational health beliefs may be a strategy for improving adherence to [cardiac rehabilitation].” – by Erik Swain
Disclosure: Anderson and Emery report no relevant financial disclosures.