Key result
Dropout during the transition from hospital to local cardiac rehabilitation was driven by a reassessment of benefits against competing agendas like work demands.
Why the study?
Despite the documented benefits of cardiac rehabilitation, attrition rates remain high and insights on patient perspectives regarding dropout during transition phases are deficient.
Patient dropout during the transition from hospital to local cardiac rehabilitation is driven by a reassessment of perceived meaningfulness, competing work demands, and changes in the exercise environment.
May support flexible cardiac rehabilitation programs addressing work demands; hypothesis-generating and should not yet change practice.
OBJECTIVES: Despite documented benefits of cardiac rehabilitation (CR), attrition rates remain relatively high. Insights on patient perspectives concerning dropout during transition phases are deficient. This deeper understanding may help to inform on the perceived benefits and barriers in CR. This qualitative study explores the reasons why patients' dropout during the transition from a hospital-based CR programme to local healthcare facilities. SETTING: A Danish hospital and seven local healthcare centres. PARTICIPANTS: Twelve patients, who had dropped out of exercise-based cardiac rehabilitation (exCR) during the transition from hospital-based rehabilitation to local healthcare centres, were recruited to semistructured interviews based on a purposeful sampling. RESULTS: Important patient needs during rehabilitation was the ability to identify and reflect oneself in a group of peers in a safe, specialised hospital-based environment. At the transition point, the meaningfulness of continuation of CR was revaluated. Findings showed that reasons for discontinuation varied within individuals. It encompassed on a balanced choice of reassessing benefits against competing agendas as work demands versus expectations of benefits in a changed exercise environment and own exercise capabilities. CONCLUSION: The study indicated that patient needs as timely relevance, a specialised safe environment and peer support are significant for participation in exCR. These needs may change during the transition stage due to competing agendas as work obligations and assessment of own ability to take control themselves. Perceived meaningfulness may be a major motivational driver for both initiating and making a judiciously choice of leaving an exCR programme.
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Damlund et al. (2022) studied Dropped out of exercise-based cardiac rehabilitation (n=12). Transition from hospital-based to local healthcare facilities for exercise-based cardiac rehabilitation was evaluated on Reasons for dropout during transition phases. Dropout during the transition from hospital to local cardiac rehabilitation was driven by a reassessment of benefits against competing agendas like work demands.
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