Educating residents about cardiac rehabilitation may improve referral rates
Referrals for cardiac rehabilitation for eligible patients increased after internal medicine residents were exposed to an educational lecture and handout, a speaker reported.
Although the number of referrals increased, further investigations with larger studies are needed because this study was not powered to detect significance, according to a presentation at the American Society for Preventive Cardiology Congress on CVD Prevention.
“Despite long-standing well-established evidence showing that cardiac rehabilitation reduces cardiovascular mortality by 26% and hospitalization rates by 28%, cardiac rehabilitation referrals remain low,” Maggie Wang, MD, internal medicine resident physician at Cedars-Sinai Medical Center, said during the presentation. “Thus, the purpose of our pilot study was to determine whether educating internists and residents on cardiac rehabilitation can help address this issue.”
For this pilot study, researchers enrolled 20 internal medicine residents rotating through an ambulatory primary care clinic, of whom 17 reported no education on cardiac rehabilitation within the past year.
According to the presentation, each participant received a 10-minute lecture based on American Heart Association guidelines and an educational handout outlining cardiac rehabilitation components, availability, indications, insurance eligibility criteria and the referral process. The primary outcome was change in referral rates of eligible patients for cardiac rehabilitation at 2 months prior to resident education and 2 months after.
Wang and colleagues found that none of the eligible patients (0 of 10) were referred to cardiac rehabilitation before education compared with 33% of eligible patients following resident education (3 of 9; P = .09).
“With that said, this pilot study was not powered to detect statistical significance, with a P value of .09,” Wang said. “We propose that further studies are needed to determine the role of resident education in improving cardiac rehabilitation referrals.
“I believe that early exposure during medical training plays a significant role in shaping how clinicians practice later in their career,” Wang told Healio. “My goal was not only to address the knowledge gap on cardiac rehabilitation amongst physicians, but also to make others aware of the barriers to utilization of cardiac rehabilitation. We know for a fact that there are disparities amongst referral rates, with minority populations, women, older patients and those who speak limited-to-no English being much less likely to be referred.”
The presentation won second place in the Early Career Presentations competition.
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Wang M, et al. Early Career Presentations. Presented at: American Society for Preventive Cardiology Congress on CVD Prevention; July 23-25, 2021 (virtual meeting).