Physical activity readiness in patient withdrawals from cardiac rehabilitation

BACKGROUND: Adherence to cardiac rehabilitation (CR) programmes may be an important element for improving and maintaining physical activity (PA) behaviour in secondary prevention. Little is known about the PA behaviour in patients who have withdrawn from CR programmes. Therefore, a study was carried out to identify the reasons for withdrawal and the stage of PA readiness in those patients previously engaged in a Leeds-based community CR programme. METHODS: A cross-sectional study was conducted using a telephone questionnaire to determine causes of withdrawal. A questionnaire based on the transtheoretical model of change was used to assess changes in PA readiness in these patients. RESULTS: 101 withdrawn patients (mean age = 61 years; 72% male) were identified. It was found that 20 patients had relapsed beyond baseline (preparation phase) into pre-contemplation and contemplation phases and 15 reported they were in the preparation phase. However, the majority of patients remained in the action (18) and maintenance (48) phases of the transtheoretical model. Patients reported the following reasons for withdrawal: joined other facilities (16%); injury or illness (3%); family demands (7%); work demands (14%); lack of motivation (4%); lack of enjoyment (11%); lack of transport (10%); lack of time (10%); too expensive (6%); too crowded (4%). CONCLUSION: 66% of patients who had withdrawn from a phase IV CR programme remained in an advanced stage of PA readiness. Drop-out was due to a combination of financial, physical and lifestyle factors.