Systematic screening and socially differentiated cardiac rehabilitation achieved an 86% referral rate, 80% attendance rate, and 71% adherence rate among patients with first-incidence MI.
Cohort (n=388)
Does systematic screening and socially differentiated cardiac rehabilitation improve referral, attendance, and adherence in patients with first myocardial infarction?
Systematic screening and socially differentiated cardiac rehabilitation programmes can achieve high referral and attendance rates, overcoming social inequalities in post-MI care.
AIM: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality in recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated cardiac rehabilitation programme. METHODS: From 1 September 2002 to 31 December 2005, 388 first-incidence MI patients ≤75 years were hospitalised. Register check for newly hospitalised MI patients, screening interview, and systematic referral were conducted by a project nurse. Patients were referred to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements. Adherence was registered until the 1-year follow up. RESULTS: 86% were referred to the CR. A large share of elderly patients and women were excluded. The attendance and adherence rates were 80% and 71%, respectively among all hospitalised patients. Among referred patients, the attendance rate was 93%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. CONCLUSIONS: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social differentiation.
Meillier et al. (Tue,) conducted a cohort in first-incidence myocardial infarction (n=388). Systematic screening and socially differentiated cardiac rehabilitation was evaluated on Referral to cardiac rehabilitation. Systematic screening and socially differentiated cardiac rehabilitation achieved an 86% referral rate, 80% attendance rate, and 71% adherence rate among patients with first-incidence MI.