Abstract 19230: Cardiac Rehabilitation Program Adherence among Women Following Referral to Different Program Models: A Randomized Controlled Trial
Background: Cardiac rehabilitation (CR) participation is associated with significantly lower mortality, however women are less likely to participate. The objectives of this trial were to test whether participation in women-only CR results in significantly greater program adherence, and subsequently greater functional capacity when compared to participation in other models.
Trial design: Single-blind, allocation-concealed pragmatic trial of female outpatients randomized to one of three CR models: (1) supervised mixed-sex; (2) supervised women-only; or (3) home-based.
Methods: Low-risk coronary artery disease patients were recruited from six hospitals in Ontario. Consenting participants completed a pre-program survey and clinical data were extracted from charts. Eligible patients were randomized, and referred to CR at one of 3 sites each offering CR delivered as per Canadian guidelines. Enrolling participants underwent a CR intake assessment including a graded exercise stress test. Participants were mailed a follow-up survey 6 months later, and CR use and exit assessment data were ascertained from CR charts. Adherence was defined as percentage of prescribed sessions completed.
Results: 264 (26.3% response rate) patients consented, of which 169 (64.0%) were randomized. 116 (68.6%) participants were retained, and were significantly older than those lost to follow-up (p<0.05). Nineteen (11.2%) participants did not enroll, and 44 (26.0%) attended a different model than the program to which they were randomly-allocated. Overall CR adherence was 66.0±28.0%, with no significant differences by randomized model (p=0.95). When considered on an “as-treated” basis, home-based participants (n=11; 87.0± 8.0%) attended a significantly greater percentage of prescribed sessions than both women’s-only (n=36; 60.1±4.4%; p=0.005) and mixed-sex (n=53; 69.2±3.6%; p=0.046) participants. There were significant increases in VO2peak across all models (ps<0.04), but no difference by model (p=0.99 by randomized group, p=0.77 as-treated).
Conclusions: Females adhered to CR at higher rates than reported in the literature, regardless of model attended. Considering the degree of cross-over, women may adhere most when given CR model choice.
Author Disclosures: L. Samayoa: None. H.M. Arthur: None. P. Oh: None. S. Brister: None. C. Chessex: None. S.L. Grace: None.
- © 2014 by American Heart Association, Inc.