Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs

ABSTRACT

Purpose: The mortality rate of cardiovascular diseases in such developing countries as Iran is on the rise. Despite sufficient evidence pointing to its efficacy, cardiac rehabilitation (CR) approach is only employed to a limited extent. In the present study, barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation model were examined.

Methods: In this study, 204 eligible patients for CR visiting an academic hospital were examined during the first three months of 2017. Patients had either abandoned rehabilitation programs midway through or had not attended one in the first place. Data about perceived barriers were collected using the modified Cardiac Rehabilitation Barriers Scale. Also, Patients’ attitude toward home-based CR was collected using a pre-validated researcher-made questionnaire.

Results: The results revealed that the most effective barriers were transportation problems (70%), travel costs (70%), considerable distance to the rehabilitation center (67%), and lack of insurance coverage for rehabilitation costs (64%), respectively. Patients with longer than 30-minute drive time were less likely to attend in training sessions in the center. In addition, the important patient expectations about home-based CR programs included: communication with specialists, training before entering the rehabilitation program, and making periodic visits to maintain motivation and adhere to the home-based CR programs.

Conclusions: The results revealed that logistical factors were the major barriers to participation in rehabilitation programs. Alternative models such as home-based CR programs, positively evaluated by the participants, can be used to overcome these barriers.

KEYWORDS:

• Cardiac rehabilitation
• coronary artery diseases
• patient non-attendance
• attitude to health
• developing countries
• mHealth

Acknowledgments

The authors would like to acknowledge Fatemeh Ebrahimi for her assistance with participant recruitment, the Research Deputy of MUMS for its financial and administrative support in this study, Imam Reza cardiac rehabilitation center for supporting this project, and all study participants for their time and effort.

Declaration of interests

The authors of this manuscript have no conflicts of interest to disclose.

Notes

1. Emerging Home Healthcare Information Technology.

Additional information

Funding

This work was supported by the Mashhad University of Medical Sciences [951201].