Contributing factors to patient non-attendance at and non-completion of Phase III cardiac rehabilitation

Background: Cardiac rehabilitation (CR) is generally underutilized. Aim: The aim of this study was to describe the rate of non-attendance after enrolment and non-completion after commencement to Phase III CR and to explore associated factors. Method: A review of medical records was carried out to determine the profile of all patients who enrolled on a CR programme. Patients who enrolled but did not attend or did not complete the programme were surveyed to ascertain the primary underlying reasons for this. A convenience sub-sample of these was then selected for semi-structured interviews (n=7) to explore the reasons for non-attendance/non-completion further. Results: Of the patients that enrolled, 11% (n=29) did not attend and 19% (n=51) did not complete the programme. The non-attendees and non-completers were significantly more likely to be unskilled manual workers (p=0.018) or smokers (p=0.001). Illness and not interested were the most common primary reasons for non-attendance and non-completion respectively. Further qualitative exploration of the contributing factors revealed exercise, depression and organizational factors contributed to these reasons. Conclusions: The study highlights that individual patient profiles and needs, if unmet contribute to poor attendance. This suggests that if these needs were identified and addressed more comprehensively throughout CR, attendance at Phase III programmes would improve. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.