The challenge of non-adherence to early rehabilitation after coronary artery bypass surgery: Secondary results from the SheppHeartCABG trial. (March 2020)

• Record Type: Journal Article
• Authors: Højskov, Ida E; Thygesen, Lau C; Moons, Philip; Egerod, Ingrid; Olsen, Peter S; Berg, Selina K
• Is Part Of: European journal of cardiovascular nursing. Volume 19:Number 3(2020)
• Page Start: 238
• Page End: 247
• Publication Date: 2020-03
• Subjects: Adherence -- early rehabilitation -- coronary artery bypass grafting -- exercise psycho-education; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515119883454
• Languages: English
• ISSNs: 1474-5151

Abstract

Background: Attending and maintaining a cardiac rehabilitation programme is a challenge. Aims: The purpose of this study was to explore associations between non-adherence to early coronary artery bypass graft rehabilitation and sociodemographic and clinical baseline data. Methods: Coronary artery bypass graft patients were randomised 1:1 to either four weeks of comprehensive early rehabilitation or usual care. Outcomes were assessed at three time-points points: baseline, discharge and four weeks post-coronary artery bypass graft. Differences in sociodemographic and clinical baseline data in adherent versus non-adherent patients were tested using the Pearson χ 2 test for categorical variables. To test associations between non-adherence to exercise training and sociodemographic and clinical baseline data, multivariate logistic regression was used to estimate the odds ratio for in-hospital training and post-discharge training adjusted for age, sex and left ventricular ejection fraction. Results: Non-adherence to in-hospital versus post-discharge exercise training was 31% ( n =48) versus 53% ( n =81). Female non-adherence was 20% versus 70%. Non-adherence to in-hospital versus post-discharge mindfulness was 87% versus 70%. Male non-adherence to mindfulness was 85% versus 70%. Non-adherence to psycho-educational consultations was 3%, most of whom were men. Patients with university level education were more adherent to in-hospital exercise training than patients with lower educational level (odds ratio=3.14 (95% confidence interval; 1.16–8.51), p =0.02). Diabetic patients were more non-adherent to exercise training after discharge (3.74 (1.54–9.08), p =0.004) as were overweight patients (0.37 (0.17–0.80), p =0.01). Conclusions: This study demonstrated wide acceptance of psycho-educational consultations in post-coronary artery bypass graft patients. Adherence to physical rehabilitation was low especially after discharge from hospital and the opportunity to attend a mindfulness programme was not used.