Comorbidities and Psychosocial Characteristics as Determinants of Dropout in Outpatient Cardiac Rehabilitation. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Pardaens, Sofie; De Smedt, Delphine; De Bacquer, Dirk; Willems, Anne-Marie; Verstreken, Sofie; De Sutter, Johan
• Is Part Of: Journal of cardiovascular nursing. Volume 32:Issue 1(2017)
• Publication Date: 2017-01
• Subjects: cardiac rehabilitation -- comorbidities -- dropout -- exercise capacity -- psychosocial characteristics; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Heart -- Diseases -- Nursing -- Periodicals; Heart -- Diseases -- Prevention -- Periodicals; 616.10231
• DOI: 10.1097/JCN.0000000000000296
• Languages: English
• ISSNs: 0889-4655

Abstract

Abstract : Background: Despite the clear benefits of cardiac rehabilitation (CR), a considerable number of patients drop out early. Objective: Therefore, we wanted to evaluate dropout in CR with a special focus on comorbidities and psychosocial background. Methods: Patients who attended CR after acute coronary syndrome, cardiac surgery, or heart failure (N = 489) were prospectively included. Dropout was defined as attending 50% of the training sessions or less (n = 96 [20%]). Demographic and clinical characteristics, exercise parameters, and psychosocial factors were analyzed according to dropout, and those with a trend toward a significant difference ( P < .10) were entered in a multivariate logistic model. Results: The presence of a cerebrovascular accident (4.18 [1.39–12.52]) involved a higher risk of dropout, and a comparable trend was seen for the presence of chronic obstructive pulmonary disease (2.55 [0.99–6.54]). Attending the training program only twice per week also implicated a higher risk of an early withdrawal (3.76 [2.23–6.35]). In contrast, patients on β-blockers were less likely to withdraw prematurely (0.47 [0.22–0.98]). Singles were more likely to drop out (2.89 [1.56–5.35]), as well as those patients who were dependent on others to get to CR (2.01 [1.16–3.47]). Finally, the reporting of severe problems on the anxiety/depression subscale of the EuroQOL-5D questionnaire involved a higher odds for dropout (7.17 [1.46–35.29]). Conclusions: Neither demographic characteristics nor clinical status or exercise capacity could independently identify patients who were at risk of dropout. The presence of comorbidities and a vulnerable psychosocial background rather seem to play a key role in dropout.