Key result
Low adherence in public cardiac rehabilitation is linked to higher total barriers versus private programs.
Why the study?
Participants in cardiac rehabilitation have low adherence, making it important to identify barriers to adherence and whether the type of service and adherence level influence them.
Does the type of cardiac rehabilitation program (public vs private) and the level of adherence influence the perceived barriers to participation?
Cross-Sectional (n=220)
No
Does the type of cardiac rehabilitation program (public vs private) and the level of adherence influence the perceived barriers to participation?
Understanding program-specific barriers to cardiac rehabilitation, such as cost, transportation, and access in public systems, is crucial for developing targeted strategies to improve patient adherence.
Answers are grounded in this paper and cite their sources.
Higher barriers in low-adherence public programs warrant attention; leaves open causal links and whether targeted interventions improve adherence.
INTRODUCTION: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. METHODS: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. RESULTS: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. CONCLUSION: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.
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Santos et al. (2023) conducted a cross-sectional in Cardiovascular disease or risk factors indicated for cardiac rehabilitation (n=220). Public cardiac rehabilitation program vs. Private cardiac rehabilitation program was evaluated on Total barriers to cardiac rehabilitation assessed by the Cardiac Rehabilitation Barriers Scale (CRBS) (p=0.023). Patients with low adherence in the public cardiac rehabilitation program presented higher total barriers compared to patients with high adherence in the private program.
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