Cardiac rehabilitation program: An exploration of patient experiences and perspectives on program dropout

Background Cardiac rehabilitation programs (CRP) are effective evidence-based secondary prevention programs that reduce morbidity and mortality in patients with cardiovascular disease (CVD). However, participation remains suboptimal, resulting in under-treatment and greater risk for recurrent cardiac events. Understanding the reasons behind CRP dropout is urgently needed to inform the development of programs that best meet patient needs and support sustained engagement. Aims The aim of this study was to identify and understand factors impacting CRP dropout from the patient perspective. Methods A qualitative study using semi-structured interviews was undertaken to examine the experience of 23 patients who dropped out of a CRP within a large urban hospital in British Columbia, Canada. Data were coded, analyzed using the constant comparison technique, and organized thematically. Results Participants described multiple challenges when attempting to complete CRP. Analysis of the data led to the identification of three main categories: (1) challenges living with CVD, (2) perceived advantages and disadvantages of CRP, and (3) unmet needs during CRP. Linking evidence to action In the practice setting, assessment of readiness to engage in CRP, alongside patient preferences and engagement needs, should be undertaken for maximum CRP uptake and completion. Providing diverse modes of CRP delivery, along with exploring the impact of virtual options as compared to traditional in-person programs, will further advance the CRP evidence and may help address pervasive access barriers.

Automated summary

This study aimed to identify and understand the factors impacting cardiac rehabilitation program (CRP) dropout from the patient perspective. Through interviews and analysis of 23 patients who dropped out of a CRP, it was found that they faced multiple challenges and made suggestions for improvement, such as conducting personalized assessments based on patient needs and providing diverse modes of program delivery.