Abstract 3179: The Association Between Patient Cardiac Risk Factors and Referral Practices to Cardiac Rehabilitation
Despite the overwhelming evidence showing the benefits of cardiac rehabilitation (CR) after Myocardial Infarction (MI), it remains highly underutilized. Limited information is available describing patient characteristics and treatments associated with CR referral practices. The study included 2294 patients from 17 US sites in the PREMIER registry that were discharged home after MI. Predictors of CR referral were determined using a multivariable hierarchical modified Poisson regression model with site-centered variables, which accounted for both clustering of patients within a hospital and confounding due to the hospital. Clinically pertinent variables were chosen a priori for inclusion in the multivariable model. Of patients discharged home, only 49.5% received referral to CR programs. Multivariable-adjusted results revealed patients with a history of chronic heart failure or coronary artery disease and those that arrived at the hospital with an acute non-cardiac condition were less likely to be referred to CR (Table⇓). Moreover other characteristics identifying patients with a strong indication for CR (e.g. smoking, less education and the presence of other comorbid diseases) were not more likely to be referred to CR. Despite existing evidence of the significant benefits of CR after MI, less than half of patients discharged home were referred to CR programs. Importantly, those with the greatest potential to benefit from CR programs were not more likely to be referred. Since CR remains underutilized by healthcare professionals, it is important to further explore barriers to CR referral and educate physicians about CR benefits to improve the implementation of the new AACVPR/ACC/AHA 2007 performance measure on CR referral.