Key result
Each additional cardiac rehab structural or process predictor linked to ~3% better post-MI dietary habits.
Why the study?
There is limited knowledge on how to optimize cardiac rehabilitation organization to motivate patients to adopt healthy dietary habits after myocardial infarction.
Do specific cardiac rehabilitation structures and processes improve self-reported dietary habits 1 year post-MI in patients?
Observational (n=5,248)
Yes
Do specific cardiac rehabilitation structures and processes improve self-reported dietary habits 1 year post-MI in patients?
Effect estimate: OR 1.03 (95% CI 1.02-1.05)
p-value: p=<0.001
Specific organizational structures and processes in cardiac rehabilitation, such as having a medical director and providing lifestyle discharge information, are associated with improved patient-reported dietary habits 1 year post-MI.
CR centre structures should not yet guide practice; this Level 3 association leaves open causal effects on post-MI diet.
AIMS: Improved dietary habits are important for successful secondary prevention after myocardial infarction (MI), with counselling and support on healthy dietary habits constituting a cornerstone of cardiac rehabilitation (CR). However, there is limited knowledge on how to optimize CR organization to motivate patients to adopt healthy dietary habits. We aimed to explore associations between CR programme structure, processes, and self-reported dietary habits 1 year post-MI. METHODS AND RESULTS: Organizational data from 73 Swedish CR centres and patient-level data from 5248 CR patients were analysed using orthogonal partial least squares discriminant analysis to identify predictors for healthy dietary habits. Variables of importance for the projection (VIP) values exceeding 0.80 were considered meaningful. Key predictors included the CR centre having a medical director [VIP (95% confidence interval)] [1.86 (1.1-2.62)], high self-reported team spirit [1.63 (1.29-1.97)], nurses have formal training in counselling methods [1.20 (0.75-1.65)], providing discharge information on risk factors [2.23 (1.82-2.64)] and lifestyle [1.81 (1.31-2.31)], time dedicated to patient interaction during follow-up [1.60 (0.80-2.40)], and centres aiming for patients to have the same nurse throughout follow-up [1.54 (1.17-1.91)]. The more positive predictors a CR centre reported to follow, the further improvement in patient-level dietary habits, were analysed by multivariable regression analysis [odds ratio for each additional positive predictor reported 1.03 (1.02-1.05), P < 0.001]. CONCLUSION: Several variables related to CR structure and processes were identified as predictors for patients reporting healthier dietary habits. These findings offer guidance for CR centres in resource allocation and optimizing patient benefits of CR attendance.
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Hag et al. (2025) conducted an observational in myocardial infarction (n=5,248). Cardiac rehabilitation programme structure and processes was evaluated on self-reported dietary habits 1 year post-MI (OR 1.03, 95% CI 1.02-1.05, p=<0.001). Each additional positive structural or process predictor in a cardiac rehabilitation centre was associated with improved dietary habits 1 year post-MI (OR 1.03; 95% CI 1.02-1.05; P<0.001).
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