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May 1992

Predictors of Cardiac Rehabilitation Participation in Older Coronary Patients

Author Affiliations
From the Divisions of Cardiology (Dr Ades and Ms Waldmann), Psychiatry (Mr McCann), and Biometry (Ms Weaver), University of Vermont College of Medicine, Medical Center Hospital of Vermont, McClure 1, Burlington.
Arch Intern Med. 1992;152(5):1033-1035. doi:10.1001/archinte.1992.00400170113021

Background.—  While older coronary patients have a lower exercise capacity than younger coronary patients and have been demonstrated to improve exercise capacity to a degree similar to younger coronary patients, they are less likely to be referred to an outpatient cardiac rehabilitation program. The goal of this study was to determine demographic, medical, and psychosocial predictors of outpatient cardiac rehabilitation participation in hospitalized older post—coronary event patients.

Methods.—  An in-hospital—guided interview was performed by the clinical research nurse of the cardiac rehabilitation program with 226 hospitalized patients, aged 62 years and older, who had recently suffered a myocardial infarction or coronary bypass surgery. Demographic, medical, and psychosocial data were analyzed.

Results. —  Overall cardiac rehabilitation participation rate in a population with a mean age of 70.4±6 years (range, 62 to 92 years) was 21%. By multivariate analysis, the strength of the primary physician's recommendation for participation was the most powerful predictor of cardiac rehabilitation entry. Also, significant predictors of participation included commute time, patient "denial" of severity of illness, and history of depression. Medical factors such as cardiac diagnosis and left ventricular ejection fraction did not predict participation.

Conclusions.—  Demographic, medical, and psychosocial data, collected in hospitalized post—coronary event patients are powerful predictors of subsequent participation in cardiac rehabilitation.(Arch Intern Med. 1992;152:1033-1035)

National Center for Health Statistics.  1986 Summary: National Hospital Discharge Survey: Advance Data From Vital and Health Survey . Hyattsville, Md: Public Health Service; 1987;6:87-1250. US Dept of Health and Human Services publication 145 (PHS).
Salter LF, Green CE, Wallace RB, Rackley CE.  Coronary artery disease in the elderly .  Am J Cardiol. 1989;63:245-248.Crossref
Ades PA, Grunvald MH.  Cardiopulmonary exercise testing before and after conditioning in older coronary patients .  Am Heart J. 1990;120:585-589.Crossref
Ades PA, Meacham CP, Handy MA, Nedde WS, Hanson JS.  The cardiac rehabilitation program of the University of Vermont Medical Center .  J Cardiopulm Rehab. 1986;6:265-277.Crossref
Hiatt AM, Hoenshell-Nelson N, Zimmerman L.  Factors influencing patient entrance into a cardiac rehabilitation program .  Cardiovasc Nurs. 1990;26:25-29.
Holka B, Cassel J, Kupper L, Burdette J.  Communication, compliance, and concordance between physicians and patients with prescribed medications .  Am J Public Health. 1976;66:847-853.Crossref
Hulka BS.  Patient-clinician interactions and compliance . In: Haynes RB, Taylor DW, Sackett DL, eds.  Compliance in Health Care. Baltimore, Md: Johns Hopkins University Press; 1979.