Abstract 031: An Innovative Home Care Delivery Model Reduces The Rate Of Dropouts Found With Traditional Cardiac Rehabilitation
Introduction: Despite recognized benefits of cardiac rehabilitation (CR), utilization of traditional centre based CR programs has been poor (16–19% of eligible patients) in Australia and USA. To address this issue, an innovative home care model (CAP), based on smart phone technologies, was developed by the Australian e-Health Research Centre and Queensland Health. The aims of this study were to assess perceived barriers of dropouts in traditional CR (TC) and observe the efficacy of the CAP in overcoming these barriers through a randomized control trial.
Method: Following consent, 120 patients from the Metro North Health Services District, Queensland, were randomised to the CAP (n=60) and control, TC (n=60) CR groups. Dropout rates were observed between the two groups and their perceived barriers were analysed through questionnaires and categorized according to: 1) life demands (work and family commitments), 2) facilitating factors (difficulties in transportation and/or parking), 3) group preference (exercise in groups), 4) medical reasons (deterioration in health), 5) technical difficulties, 6) lack of motivation, 7) lack of need for CR (due to improvement in health) and 8) other reasons. The dropout rates were analysed by the two sided Fisher’s exact test in SPSSvs16.
Results: Patients’ ages (Mean±SD) between the CAP (59±12 yrs) and TC (59±9 yrs) groups were similar. Dropouts for the TC were mainly due to Categories 1 and 2 (C1TC =21.7%, C2TC =21.7%); and they were reduced significantly (p<0.05) for CAP (C1CAP=5.0%, C2CAP=3.3%). No significant difference was found for the remaining categories between the two groups. Category 7 was not responsible for any dropouts in either of the groups.
Conclusion: The study demonstrates that both competing life demands and facilitating factors were the key barriers to patient dropouts from traditional CR programs, despite patients’ recognition of need to participate in the CR programs. The CAP was able to overcome these two barriers, and hence improve the rate of utilization of CR programs.
- © 2012 by American Heart Association, Inc.