Patterns and Predictors of Uptake and Adherence to Cardiac Rehabilitation

PURPOSE: Despite the recognized effectiveness of cardiac rehabilitation (CR), these programs are frequently reported to be underutilized. This prospective Study sought to describe the uptake of and adherence to phase 3 of a CR service in Glasgow, UK. METHODS: The study recorded psychological, social, and demographic characteristics of patients in an attempt to ascertain variables associated with failure to initiate attendance or poor adherence to the program. Consecutive patients (N = 91) were included in the study before inviting them to participate in a comprehensive CR program. RESULTS: Thirty-one (35%) patients eligible to attend phase 3 CR indicated no intention to attend the program. A further 31 (35%) patients were considered nonadherent to the program. No factors predicting initiation or adherence emerged as significant. More than two-thirds of the patients eligible for CR did not engage in the program either through failure to initiate rehabilitation or poor adherence following initiation. CONCLUSION: Alternative means of service delivery should be considered to broaden access to CR. Psychological interventions aimed at enhancing motivation and adherence should be developed and appropriately evaluated.