Exploring the Impediments: Investigating Barriers to Participation in Phase-2 Cardiac Rehabilitation Following Coronary Artery Bypass Graft Among Thai Patients

Background: Despite the known benefits of cardiac rehabilitation (CR), the rate of participation is low following coronary artery bypass graft (CABG). The reasons for this lack of participation are unclear and there have been few studies investigating this, particularly in Asian countries. The present study aimed to address this lack of information and identify reasons for non-participation in phase-2 CR among patients who underwent CABG. Methods: We enrolled 42 patients who underwent CABG or CABG combined with valvular heart surgery in a university hospital between October 2016 to September 2018. Patients who participated in phase-1 but not phase-2 CR were interviewed by phone following an 11-item questionnaire. Results: The rate of participation in phase-2 CR was only 12.5%. The most frequently reported reason for non-participation was "Did not know that there was phase-2 CR" (61.9%), followed by "Transportation problems" (31%). "Unable to take leave due to work schedule" was fairly frequently reported (19%) as was "Did not participate due to chronic diseases and complications" (14.3%). Conclusion: Our study revealed low participation in phase-2 CR, despite its well-known benefits. The primary reason identified was a lack of awareness and understanding among patients regarding phase-2 CR. This highlights the need for targeted interventions aimed at increasing knowledge and awareness of the benefits and availability of CR. Additionally, it is crucial to establish an efficient referral system that ensures seamless transitions from the initial cardiac treatment to the rehabilitation phase. Implementing these strategies is expected to boost CR participation, leading to improved patient outcomes and overall cardiac health.