Implementation of an age-inclusive cardiac rehabilitation logic model increased referrals by 24%, enrolment by 17%, and completion rates by 14% (all p<0.05) among elderly patients over 6 months.
Does an age-inclusive logic model improve cardiac rehabilitation referral, enrolment, and completion rates in patients aged ≥70 years?
A tailored logic model integrating patient, provider, and system-level interventions significantly improves cardiac rehabilitation uptake and completion in elderly patients.
p-value: p=<0.05
Abstract Background Despite robust evidence supporting cardiac rehabilitation (CR) in reducing morbidity and mortality, elderly patients remain significantly underrepresented in CR programs (1). Barriers include age-related bias, multimorbidity, transportation challenges, and lack of tailored interventions (2,3). Addressing these gaps is critical, as older adults derive substantial benefit from structured secondary prevention. This study proposes a logic model to guide the development and implementation of age-inclusive CR pathways, aiming to overcome barriers and optimize outcomes in patients aged ≥70 years. Methods We conducted a targeted literature review and stakeholder consultation within a regional cardiac centre in United Kingdom to identify determinants of CR underuse in elderly patients (3). Using intervention mapping methodology, we developed a logic model integrating patient-level, provider-level, and system-level factors. Key inputs included multidisciplinary expertise, telehealth infrastructure, and frailty-adapted exercise protocols. Activities encompassed automatic referral prompts, caregiver engagement, and hybrid CR formats (4). Outputs were defined as increased referral, enrolment, and completion rates. Pre- and post-implementation outcomes were compared using descriptive statistics, with pilot data collected over a 6-month period. All findings represent preliminary data intended to inform larger-scale evaluation. Results The proposed logic model outlines a stepwise framework linking tailored CR activities to short- and long-term outcomes (Table 1). Short-term outcomes include improved awareness, reduced logistical barriers, and enhanced patient engagement. Long-term outcomes target reduced rehospitalization, improved functional independence, and integration of CR into routine geriatric cardiac care. In a regional cardiac centre in United Kingdom, pilot implementation was associated with a 24% rise in CR referrals (p0.05), a 17% increase in enrolment (p0.05), and a 14% improvement in completion rates (p0.05) among elderly patients over 6 months. These findings highlight the feasibility of embedding age-inclusive strategies into routine practice and demonstrate measurable gains in participation. Conclusion This logic model offers a scalable framework to address the underuse of CR in elderly populations. By aligning preventive cardiology goals with implementation science, it supports age-inclusive rehabilitation strategies that can be adapted across diverse healthcare settings. Preliminary results suggest that structured, tailored interventions can significantly improve CR uptake and completion in older adults, underscoring the importance of integrating geriatric principles into preventive cardiology.Table 1For image description, please refer to the figure legend and surrounding text.
Nakou et al. (Mon,) conducted a other in Cardiac rehabilitation underuse. Age-inclusive cardiac rehabilitation logic model vs. Pre-implementation routine care was evaluated on Cardiac rehabilitation referrals, enrolment, and completion rates (p=<0.05). Implementation of an age-inclusive cardiac rehabilitation logic model increased referrals by 24%, enrolment by 17%, and completion rates by 14% (all p<0.05) among elderly patients over 6 months.