Abstract 14955: An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation: A Randomized, Single-Blind, Controlled Trial

Abstract

Background: Outpatient cardiac rehabilitation (CR) decreases mortality rates but is underutilized. Current median time from hospital discharge to enrollment is 35 days. We hypothesized that an early appointment within 10 days would improve attendance at CR orientation.

Methods and Results: At hospital discharge, 148 patients with a non-surgical qualifying diagnosis for cardiac rehabilitation were blindly randomized to receive a CR orientation appointment either within 10 days (early, E) or at 35 days (standard, STD). The primary endpoint was attendance at CR orientation. Secondary outcome measures were attendance at ≥ 1 exercise session, the total number of exercise sessions attended, completion of CR, and change in exercise training work load while in CR. Average age was 60 ± 12 yrs., 56% male, 49% Black, with balanced baseline characteristics between groups. Time to orientation was 10 ± 7 vs. 34 ± 10 days for the E and STD groups, respectively (p < 0.001). Attendance rates at the orientation session were 57/74 (77%) vs. 44/74 (59%) for E and STD groups respectively, demonstrating a significant 18% absolute and 56% relative improvement in attendance (RR 1.56, 95% CI, 1.03 to 2.37; p = 0.022). The number needed to treat was 5.7. There was no difference (p>0.05) in any of the secondary outcome measures but statistical power for these endpoints was low. Safety analysis demonstrated no difference between groups in CR-related adverse events. See table for complete results.

Conclusions: Early appointments to CR significantly improve attendance at orientation. This simple technique could potentially increase CR participation nationwide. Clinical Trial Registration: http://clinicaltrials.gov. Unique identifier: NCT01596036