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Promoting patient uptake and adherence in cardiac rehabilitation.

Abstract

BACKGROUND

Cardiac rehabilitation is an important component of recovery from coronary events but uptake and adherence to such programmes are below the recommended levels. This aim is to update a previous non-Cochrane systematic review which examined interventions that may potentially improve cardiac patient uptake and adherence in rehabilitation or its components and concluded that there is insufficient evidence to make specific recommendations.

OBJECTIVES

To determine the effects of interventions to increase patient uptake of, and adherence to, cardiac rehabilitation.

SEARCH STRATEGY

A previous systematic review identified studies published prior to June 2001. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 4 2007), MEDLINE (2001 to January 2008), EMBASE (2001 to January 2008), CINAHL (2001 to January 2008), PsycINFO (2001 to January 2008), Web of Science: ISI Proceedings (2001 to April 2008), and NHS Centre for Reviews and Dissemination (CRD) databases (Health Technology Assessment (HTA) and Database of Abstracts of Reviews of Effects (DARE)) from 2001 to January 2008. Reference lists of identified systematic reviews and randomised control trials (RCTs) were also checked for additional studies.

SELECTION CRITERIA

Adults with myocardial infarction, coronary artery bypass graft, percutaneous transluminal coronary angioplasty, heart failure, angina, or coronary heart disease eligible for cardiac rehabilitation and randomised or quasi-randomised trials of interventions to increase uptake or adherence to cardiac rehabilitation or any of its component parts. Only studies reporting a measure of adherence were included.

DATA COLLECTION AND ANALYSIS

Titles and abstracts of all identified references were screened for eligibility by two reviewers independently and full papers of potentially relevant trials were obtained and checked. Included studies were assessed for risk of bias by two reviewers.

MAIN RESULTS

Ten studies were identified, three of interventions to improve uptake of cardiac rehabilitation and seven of interventions to increase adherence. Meta-analysis was not possible due to multiple sources of heterogeneity. All three interventions targeting uptake of cardiac rehabilitation were effective. Two of seven studies intended to increase adherence had a significant effect. Only one study reported the non-significant effects of the intervention on cardiovascular risk factors and no studies reported data on mortality, morbidities, costs or health care resource utilisation.

AUTHORS' CONCLUSIONS

There is some evidence to suggest that interventions to increase the uptake of cardiac rehabilitation can be effective. Few practice recommendations for increasing adherence to cardiac rehabilitation can be made at this time. Interventions targeting patient identified barriers may increase the likelihood of success. Further high quality research is needed.

Authors+Show Affiliations

Academic Unit of Psychiatry, Community Based Medicine, University of Bristol, Cotham House, Cotham, Bristol, UK, BS6 6JL.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

20614453

Citation

Davies, Philippa, et al. "Promoting Patient Uptake and Adherence in Cardiac Rehabilitation." The Cochrane Database of Systematic Reviews, 2010, p. CD007131.
Davies P, Taylor F, Beswick A, et al. Promoting patient uptake and adherence in cardiac rehabilitation. Cochrane Database Syst Rev. 2010.
Davies, P., Taylor, F., Beswick, A., Wise, F., Moxham, T., Rees, K., & Ebrahim, S. (2010). Promoting patient uptake and adherence in cardiac rehabilitation. The Cochrane Database of Systematic Reviews, (7), CD007131. https://doi.org/10.1002/14651858.CD007131.pub2
Davies P, et al. Promoting Patient Uptake and Adherence in Cardiac Rehabilitation. Cochrane Database Syst Rev. 2010 Jul 7;(7)CD007131. PubMed PMID: 20614453.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Promoting patient uptake and adherence in cardiac rehabilitation. AU - Davies,Philippa, AU - Taylor,Fiona, AU - Beswick,Andrew, AU - Wise,Frances, AU - Moxham,Tiffany, AU - Rees,Karen, AU - Ebrahim,Shah, Y1 - 2010/07/07/ PY - 2010/7/9/entrez PY - 2010/7/9/pubmed PY - 2010/8/12/medline SP - CD007131 EP - CD007131 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 7 N2 - BACKGROUND: Cardiac rehabilitation is an important component of recovery from coronary events but uptake and adherence to such programmes are below the recommended levels. This aim is to update a previous non-Cochrane systematic review which examined interventions that may potentially improve cardiac patient uptake and adherence in rehabilitation or its components and concluded that there is insufficient evidence to make specific recommendations. OBJECTIVES: To determine the effects of interventions to increase patient uptake of, and adherence to, cardiac rehabilitation. SEARCH STRATEGY: A previous systematic review identified studies published prior to June 2001. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 4 2007), MEDLINE (2001 to January 2008), EMBASE (2001 to January 2008), CINAHL (2001 to January 2008), PsycINFO (2001 to January 2008), Web of Science: ISI Proceedings (2001 to April 2008), and NHS Centre for Reviews and Dissemination (CRD) databases (Health Technology Assessment (HTA) and Database of Abstracts of Reviews of Effects (DARE)) from 2001 to January 2008. Reference lists of identified systematic reviews and randomised control trials (RCTs) were also checked for additional studies. SELECTION CRITERIA: Adults with myocardial infarction, coronary artery bypass graft, percutaneous transluminal coronary angioplasty, heart failure, angina, or coronary heart disease eligible for cardiac rehabilitation and randomised or quasi-randomised trials of interventions to increase uptake or adherence to cardiac rehabilitation or any of its component parts. Only studies reporting a measure of adherence were included. DATA COLLECTION AND ANALYSIS: Titles and abstracts of all identified references were screened for eligibility by two reviewers independently and full papers of potentially relevant trials were obtained and checked. Included studies were assessed for risk of bias by two reviewers. MAIN RESULTS: Ten studies were identified, three of interventions to improve uptake of cardiac rehabilitation and seven of interventions to increase adherence. Meta-analysis was not possible due to multiple sources of heterogeneity. All three interventions targeting uptake of cardiac rehabilitation were effective. Two of seven studies intended to increase adherence had a significant effect. Only one study reported the non-significant effects of the intervention on cardiovascular risk factors and no studies reported data on mortality, morbidities, costs or health care resource utilisation. AUTHORS' CONCLUSIONS: There is some evidence to suggest that interventions to increase the uptake of cardiac rehabilitation can be effective. Few practice recommendations for increasing adherence to cardiac rehabilitation can be made at this time. Interventions targeting patient identified barriers may increase the likelihood of success. Further high quality research is needed. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20614453/Promoting_patient_uptake_and_adherence_in_cardiac_rehabilitation_ L2 - https://doi.org/10.1002/14651858.CD007131.pub2 DB - PRIME DP - Unbound Medicine ER -